Association between Behavioral Economic Incentives (BEI) and Food Security in Improving Antiretroviral (ARV) Medication Adherence among HIV Positive Patients At Mildmay Clinic in Kampala, Uganda

Abstract

Behavioural economic incentives have successfully improved health behaviours across a wide range of settings. In this study, we investigate the associations in Rewarding Adherence Program (RAP), behavioural economic incentives, and food security in promoting proper antiretroviral (ARV) medication adherence. 155 HIV-infected men and women ages 19–78 were randomized into one of two intervention groups and received small prizes of US $1.50 awarded through a drawing conditional on either attending scheduled clinic appointments or achieving at least 90% mean ARV adherence. The control group received the usual standard of care. I conducted univariate bivariate and logistic regression analysis to find the association between mean adherence, food security and Behavioural Economics Incentives. I found that treatment was significant plus gender and age at month 20 of the intervention (T = 2.15pp; SD 0.215 pp, p-value = 0.034), (T = 3.53 pp; SD 0.215pp, p-value = 0.001) and (T = 3.01 pp; SD 0.215 pp, p-value = 0.001), (pp= per person) at 95% confidence interval showing that there is association between mean adherence and behavioural economics incentives. And also gender and age were statistically significant at the same confidence level. On the other hand, food security was not statistically significant hence showing that there is no association between mean adherence and food security. Behavioural economic incentives are an effective mechanism for increasing many patients’ mean ARV adherence, even though more studies should be done to explore the association between food security and mean adherence.