Evidence map›Paper›PMID 38695099›Full record

Trial reportJournal of the International AIDS Society2024

Population impacts of conditional financial incentives and a male-targeted digital decision support application on the HIV treatment cascade in rural KwaZulu Natal: findings from the HITS cluster randomized clinical trial.

Maxime Inghels, Hae-Young Kim, Thulile Mathenjwa, Maryam Shahmanesh, Janet Seeley, Sally Wyke, Philippa Matthews, Oluwafemi Adeagbo, Dickman Gareta, Nuala McGrath and 6 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of the International AIDS Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 41% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors at 10 institutions in 6 countries.

Maxime InghelsLincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK.ORCID 0000-0002-9340-2054
Hae-Young KimAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0001-9797-0000
Thulile MathenjwaAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0003-2436-9972
Maryam ShahmaneshAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0001-7129-8535
Janet SeeleyAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0002-0583-5272
Sally WykeSchool of Social and Political Sciences, School of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID 0000-0002-7509-8247
Philippa MatthewsAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0002-6157-9680
Oluwafemi AdeagboDepartment of Sociology, University of Johannesburg, Johannesburg, South Africa.ORCID 0000-0003-1462-9275
Dickman GaretaAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0002-4004-5655
Nuala McGrathAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0002-1039-0159
H Manisha YapaAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0002-0100-4754
Ann BlandfordUniversity College London Interaction Centre, University College London, London, UK.ORCID 0000-0002-3198-7122
Thembelihle ZumaAfrica Health Research Institute, KwaZulu-Natal, South Africa.
Adrian DobraUniversity of Washington, Seattle, Washington, USA.ORCID 0000-0001-7793-2197
Till BärnighausenAfrica Health Research Institute, KwaZulu-Natal, South Africa.ORCID 0000-0002-4182-4212
Frank TanserAfrica Health Research Institute, KwaZulu-Natal, South Africa.
Africa Health Research Institute · ZAHeidelberg University · DEInserm · FRLondon Centre for Nanotechnology · GBLondon School of Hygiene & Tropical Medicine · GBStellenbosch University · ZAThe University of Sydney · AUUniversity of Glasgow · GBUniversity of Iowa · USUniversity of Washington · US

Funding

Causal Pathways to population health impact of HIV antiretroviral treatmentR01HD084233 · NICHD · UNIVERSITY OF KWAZULU-NATAL · PI BARNIGHAUSEN, TILL, TANSER, FRANK COURTENEY · 2015 to 2021
$2.3M
Can HIV Hot-Spots be eradicated? An intervention to decrease HIV transmission to young women in rural KwaZulu-Natal South AfricaR01AI124389 · NIAID · UNIVERSITY OF KWAZULU-NATAL · PI BARNIGHAUSEN, TILL, TANSER, FRANK COURTENEY · 2016 to 2020
$2.1M
The changing face of HIV in the era of COVID-19: Maximising HIV incidence reduction through dynamic targeting of current and future distributions of acquisition risk.R01MH131480 · NIMH · STELLENBOSCH UNIVERSITY · PI Henry Godwell Mwambi, Frank Courteney Tanser · 2023 to 2026
$2.0M
Understanding causal pathways of HIV acquisition and transmission: a multi-level,R01HD058482 · NICHD · UNIVERSITY OF KWAZULU-NATAL · PI BARNIGHAUSEN, TILL, TANSER, FRANK COURTENEY · 2008 to 2012
$1.2M
NIAID NIH HHS R01 AI124389NICHD NIH HHS R01 HD058482NICHD NIH HHS R01 HD084233NIH HHS R01-HD084233NIMH NIH HHS R01 MH131480Wellcome TrustWellcome Trust 201433/A/16/A
6 · The paper itself

Abstract

introductionIn South Africa, the HIV care cascade remains suboptimal. We investigated the impact of small conditional financial incentives (CFIs) and male-targeted HIV-specific decision-support application (EPIC-HIV) on the HIV care cascade.

methodsIn 2018, in uMkhanyakude district, 45 communities were randomly assigned to one of four arms: (i) CFI for home-based HIV testing and linkage to care within 6 weeks (R50 [US$3] food voucher each); (ii) EPIC-HIV which are based on self-determination theory; (iii) both CFI and EPIC-HIV; and (iv) standard of care. EPIC-HIV consisted of two components: EPIC-HIV 1, provided to men through a tablet before home-based HIV testing, and EPIC-HIV 2, offered 1 month later to men who tested positive but had not yet linked to care. Linking HITS trial data to national antiretroviral treatment (ART) programme data and HIV surveillance programme data, we estimated HIV status awareness after the HITS trial implementation, ART status 3 month after the trial and viral load suppression 1 year later. Analysis included all known individuals living with HIV in the study area including those who did not participated in the HITS trial.

resultsAmong the 33,778 residents in the study area, 2763 men and 7266 women were identified as living with HIV by the end of the intervention period and included in the analysis. After the intervention, awareness of HIV-positive status was higher in the CFI arms compared to non-CFI arms (men: 793/908 [87.3%] vs. 1574/1855 [84.9%], RR = 1.03 [95% CI: 0.99-1.07]; women: 2259/2421 [93.3%] vs. 4439/4845 [91.6%], RR = 1.02 [95% CI: 1.00-1.04]). Three months after the intervention, no differences were found for linkage to ART between arms. One year after the intervention, only 1829 viral test results were retrieved. Viral suppression was higher but not significant in the EPIC-HIV intervention arms among men (65/99 [65.7%] vs. 182/308 [59.1%], RR = 1.11 [95% CI: 0.88-1.40]).

conclusionsSmall CFIs can contribute to achieve the first step of the HIV care cascade. However, neither CFIs nor EPIC-HIV was sufficient to increase the number of people on ART. Additional evidence is needed to confirm the impact of EPIC-HIV on viral suppression.

Indexed as

HIV InfectionsMotivationRural PopulationAdolescentAdultFemaleHIV TestingHumansMaleMiddle AgedSouth AfricaYoung Adultcounsellingfinancial incentivesHIVHIV care cascadehome‐based HIV testingmHealth

Identifiers

PMID38695099
PMCPMC11063775
OpenAlexW4396585826

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.