Financial incentives increased the number of children and adolescents who came to a clinic in Harare, Zimbabwe, for HIV testing, a randomized trial published in The Lancet found.
Field workers enrolled 1,688 households with children between 8 and 17 years of age in this sub-study of an HIV prevalence survey. Each household was assigned to either receive US$2, be entered in a lottery for a one-in-eight chance of winning US$5 or US$10, or get no incentive; eligibility was based on whether at least one child in the household was tested at the clinic within four weeks of enrollment.
The fixed payment yielded the greatest proportion of households tested (48% of that arm), followed by the lottery (40%), and trailed by no incentive (20%). Testing was only available during business hours, which might have affected the low uptake in the no payment arm, study authors hypothesized.
Participants' monthly household income is about US$100, a related comment noted. Payments offered thus represent 2%-10% of monthly incomes. Such incentive programs might set up expectations that could lead people to refuse an HIV test if they do not receive compensation, the comment authors warned. Nonetheless, relatively small incentives may save medical costs in the long run by identifying and treating hard-to-reach populations early on, they conceded.
Barbara Jungwirth is a freelance writer and translator based in New York. Follow Barbara on Twitter: @reliabletran.
Myles Helfand is the executive editor and general manager of TheBody.com and TheBodyPRO.com. Follow Myles on Twitter: @MylesatTheBody.