Trial reportJAMA2016
Effect of Patient Navigation With or Without Financial Incentives on Viral Suppression Among Hospitalized Patients With HIV Infection and Substance Use: A Randomized Clinical Trial.
Trial report in JAMA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01612169 (NIDA CTN Protocol 0049. Project HOPE -- Hospital Visit as Opportunity for Prevention and Engagement for HIV-Infected Drug Users), which is not on this map. Cited by 139 papers, 11 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
NIDA CTN Protocol 0049. Project HOPE -- Hospital Visit as Opportunity for Prevention and Engagement for HIV-Infected Drug Users
Who cites it
139 citing papers in PubMed, 11 syntheses or guidelines pooled it.
- Community care navigation intervention for people who are at risk of unplanned hospital presentations.The Cochrane database of systematic reviews · 2025Pooled it
- Effectiveness of financial incentives for control of viral hepatitis among substance users: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- Promoting HIV care continuum outcomes among people who use drugs and alcohol: a systematic review of randomized trials evaluating behavioral HIV care interventions published from 2011 to 2023.BMC public health · 2023Pooled it
- Running with Scissors: a Systematic Review of Substance Use and the Pre-exposure Prophylaxis Care Continuum Among Sexual Minority Men.Current HIV/AIDS reports · 2022Pooled it
- Psychosocial Interventions to Promote Undetectable HIV Viral Loads: A Systematic Review of Randomized Clinical Trials.AIDS and behavior · 2022Pooled it
- Improving Post-Release Care Engagement for People Living with HIV Involved in the Criminal Justice System: A Systematic Review.AIDS and behavior · 2022Pooled it
- The Utilisation of Payment Models Across the HIV Continuum of Care: Systematic Review of Evidence.AIDS and behavior · 2021Pooled it
- A need for implementation science to optimise the use of evidence-based interventions in HIV care: A systematic literature review.PloS one · 2019Pooled it
- Is HIV patient navigation associated with HIV care continuum outcomes?AIDS (London, England) · 2018Pooled it
- Guideline
- Pooled it
- Clinical and behavioral predictors of HIV-associated neurocognitive disorder among people with HIV who use substances: a secondary analysis of the HOPE trial.Journal of neurovirology · 2026Trial
- The COMEBACK Study: Social Determinants of Health Impact on Virologic Suppression in a 48-Week Low-Barrier-Care Study of Rapid Antiretroviral Therapy Reinitiation Among Persons With HIV Lost to Care.Open forum infectious diseases · 2026Trial
- Impact of financial incentives on viral suppression among adults initiating HIV treatment in Tanzania: a hybrid effectiveness-implementation trial.The lancet. HIV · 2024Trial
- A positive affect intervention alters leukocyte DNA methylation in sexual minority men with HIV who use methamphetamine.Brain, behavior, and immunity · 2024Trial
- Voucher incentives to improve viral suppression among HIV-positive people who inject drugs and men who have sex with men in India: a cluster randomised trial.The lancet. HIV · 2024Trial
- Patient navigation for pregnant individuals with opioid use disorder: Results of a randomized multi-site pilot trial.Addiction (Abingdon, England) · 2024Trial
- Long-Term Effects of Incentives for HIV Viral Suppression: A Randomized Clinical Trial.AIDS and behavior · 2024Trial
- Increasing Prenatal Care Compliance in At-Risk Black Women: Findings from a RCT of Patient Navigation and Behavioral Incentives.Journal of racial and ethnic health disparities · 2022Trial
- Cost and Cost-Effectiveness of Incentives for Viral Suppression in People Living with HIV.AIDS and behavior · 2022Trial
79 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
32 authors.
Funding
Abstract
importanceSubstance use is a major driver of the HIV epidemic and is associated with poor HIV care outcomes. Patient navigation (care coordination with case management) and the use of financial incentives for achieving predetermined outcomes are interventions increasingly promoted to engage patients in substance use disorders treatment and HIV care, but there is little evidence for their efficacy in improving HIV-1 viral suppression rates.
objectiveTo assess the effect of a structured patient navigation intervention with or without financial incentives to improve HIV-1 viral suppression rates among patients with elevated HIV-1 viral loads and substance use recruited as hospital inpatients. DESIGN, SETTING, AND
participantsFrom July 2012 through January 2014, 801 patients with HIV infection and substance use from 11 hospitals across the United States were randomly assigned to receive patient navigation alone (n = 266), patient navigation plus financial incentives (n = 271), or treatment as usual (n = 264). HIV-1 plasma viral load was measured at baseline and at 6 and 12 months.
interventionsPatient navigation included up to 11 sessions of care coordination with case management and motivational interviewing techniques over 6 months. Financial incentives (up to $1160) were provided for achieving targeted behaviors aimed at reducing substance use, increasing engagement in HIV care, and improving HIV outcomes. Treatment as usual was the standard practice at each hospital for linking hospitalized patients to outpatient HIV care and substance use disorders treatment. MAIN OUTCOMES AND MEASURES: The primary outcome was HIV viral suppression (≤200 copies/mL) relative to viral nonsuppression or death at the 12-month follow-up.
resultsOf 801 patients randomized, 261 (32.6%) were women (mean [SD] age, 44.6 years [10.0 years]). There were no differences in rates of HIV viral suppression versus nonsuppression or death among the 3 groups at 12 months. Eighty-five of 249 patients (34.1%) in the usual-treatment group experienced treatment success compared with 89 of 249 patients (35.7%) in the navigation-only group for a treatment difference of 1.6% (95% CI, -6.8% to 10.0%; P = .80) and compared with 98 of 254 patients (38.6%) in the navigation-plus-incentives group for a treatment difference of 4.5% (95% CI -4.0% to 12.8%; P = .68). The treatment difference between the navigation-only and the navigation-plus-incentives group was -2.8% (95% CI, -11.3% to 5.6%; P = .68). CONCLUSIONS AND RELEVANCE: Among hospitalized patients with HIV infection and substance use, patient navigation with or without financial incentives did not have a beneficial effect on HIV viral suppression relative to nonsuppression or death at 12 months vs treatment as usual. These findings do not support these interventions in this setting.
trial registrationclinicaltrials.gov Identifier: NCT01612169.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.