Trial reportJournal of the International AIDS Society2020
Lottery incentives have short-term impact on ART initiation among men: results from a randomized pilot study.
Trial report in Journal of the International AIDS Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03808194 (The Lotto to Link Study), which is not on this map. Cited by 23 papers, 3 of them syntheses that pooled it.
What it found
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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.
The Lotto to Link Study: A Prospective, Interventional, Randomized Study of Conditional Incentives to Engage HIV-positive Men in HIV Care in KwaZulu-Natal, South Africa
Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The Impact of Behavioural Economics-Informed Interventions on the Care Cascade for Sexually Transmitted and Blood-Borne Infections: A Systematic Review of Randomized Controlled Trials.Journal of the International AIDS Society · 2026Pooled it
- The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysis.AIDS research and therapy · 2025Pooled it
- Effectiveness of Behavioural Economics Informed Interventions for the Prevention, Screening, and Antiretroviral Treatment of HIV Infection: A Systematic Review of Randomized Controlled Trials.AIDS and behavior · 2023Pooled it
- Effects of a Lottery Incentive on STI/HIV Incidence Among Female Sex Workers in Tanzania: Outcomes of Rewarding STI Prevention and Control in Tanzania (RESPECT-2).AIDS and behavior · 2025Trial
- Incentivizing adherence to pre-exposure prophylaxis for HIV prevention: a randomized pilot trial among male sex workers in Mexico.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Trial
- Trial
- Effect of a one-time financial incentive on linkage to chronic hypertension care in Kenya and Uganda: A randomized controlled trial.PloS one · 2022Trial
- Lottery incentives have short-term impact on ART initiation among men: results from a randomized pilot study.Journal of the International AIDS Society · 2020Trial
- Incentive-based interventions to improve HIV prevention and care continuum: a global systematic review and meta-analysis.EClinicalMedicine · 2026Article
- Community-Partnered Development of Behavioral Economic Incentives in a Pre-exposure Prophylaxis Intervention for Transgender and Nonbinary Clients in Los Angeles.Research square · 2025Article
- Stakeholder priorities for ART initiation and early retention strategies in Malawi: a qualitative study comparing international and national perspectives.BMC public health · 2025Article
- A 5-Year Review of the Impact of Lottery Incentives on HIV-Related Services.Current HIV/AIDS reports · 2024Review
- Understanding effective post-test linkage strategies for HIV prevention and care: a scoping review.Journal of the International AIDS Society · 2024Article
- Stakeholder Priorities for ART Initiation and Early Retention Interventions in Malawi: A Qualitative Study Comparing International and National Perspectives.Research square · 2023Article
- Strategies to improve antiretroviral therapy (ART) initiation and early engagement among men in sub-Saharan Africa: A scoping review of interventions in the era of universal treatment.Tropical medicine & international health : TM & IH · 2023Article
- Applying Behavioural Insights to HIV Prevention and Management: a Scoping Review.Current HIV/AIDS reports · 2022Article
- Protocol: evaluation of an optimised couples-focused intervention to increase testing for HIV in rural KwaZulu-Natal, South Africa, the Igugu Lethu ('Our treasure') cohort study.BMC public health · 2022Article
- Understanding Repeat Positive HIV Testing in South Africa Under Changing Treatment Guidelines.AIDS and behavior · 2022Article
- How mHealth Can Contribute to Improving the Continuum of Care: A Scoping Review Approach to the Case of Human Immunodeficiency Virus in Sub-Saharan Africa.Public health reviews · 2022Article
- "The Money, It's OK but It's not OK": Patients' and Providers' Perceptions of the Acceptability of Cash Incentives for HIV Treatment Initiation in Cape Town, South Africa.AIDS and behavior · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
Abstract
introductionAmong people living with HIV in South Africa, viral suppression is lower among men than women. The study aim was to test the impact of lottery incentives, which reward positive health choice (e.g. antiretroviral therapy (ART) linkage) with a chance to win a prize, on strengthening the HIV care continuum including ART initiation and viral suppression for men.
methodsWe conducted a randomized, prospective trial of lottery incentives in the context of HIV testing and linkage to ART in rural KwaZulu-Natal, South Africa. Men living with HIV were randomly allocated to: lottery incentives and motivational text messages or motivational text messages only. Lottery prize eligibility was conditional on clinic registration, ART initiation, or viral suppression by one, three and six months respectively. After completing each continuum step, participants in the lottery group were notified whether they had won and were encouraged to continue in care. Lottery prizes were either a mobile phone, data or a gift card (valued at R1000/$100). Kaplan-Meier curves were plotted to determine time to ART initiation by study group. The primary outcome was viral suppression at six months.
resultsBetween November 2017 and December 2018, we tested 740 men for HIV and enrolled 131 HIV-positive men who reported not being on ART. At baseline, 100 (76%) participants were 30 years and older, 95 (73%) were unemployed and the median CD4 count was 472 cells/μL. At study exit, 84% (110/131) of participants had visited a clinic and 62% (81/131) were virally suppressed. Compared to motivational text messages, lottery incentives decreased the median time to ART initiation from 126 to 66 days (p = 0.0043, age-adjusted Cox regression) among all participants, and, from 134 days to 20 days (p = 0.0077) among participants who were not virally suppressed at baseline. Lottery incentives had an inconclusive effect on clinic registration (RR = 1.21, 95% CI: 0.83 to 1.76) and on viral suppression at six months (RR = 1.13, 95% CI: 0.73 to 1.75) compared to motivational text messages.
conclusionsConditional lottery incentives shortened the time to ART initiation among South African men. Behavioural economics strategies strengthen linkage to ART, but the study power was limited to see an impact on viral suppression. CLINICAL TRIAL NUMBER: NCT03808194.
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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.