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dc.contributor.authorAlsan, Marcella
dc.contributor.authorBeshears, John Leonard
dc.contributor.authorArmstrong, Wendy S.
dc.contributor.authorChoi, James J.
dc.contributor.authorMadrian, Brigitte
dc.contributor.authorNguyen, Minh Ly T.
dc.contributor.authorDel Rio, Carlos
dc.contributor.authorLaibson, David I.
dc.contributor.authorMarconi, Vincent C.
dc.date.accessioned2018-06-12T17:36:19Z
dc.date.issued2017
dc.identifierQuick submit: 2018-01-17T12:13:47-0500
dc.identifier.citationAlsan, Marcella, John Beshears, Wendy S. Armstrong, James J. Choi, Brigitte C. Madrian, Minh Ly T. Nguyen, Carlos Del Rio, David Laibson, and Vincent C. Marconi. "A Commitment Contract to Achieve Virologic Suppression in Poorly Adherent Patients with HIV/AIDS." AIDS 31, no. 12 (July 31, 2017): 1765–1769. doi:10.1097/qad.0000000000001543.en_US
dc.identifier.issn0269-9370en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:37101476
dc.description.abstractObjective: Assess whether a commitment contract informed by behavioral economics leads to persistent virologic suppression among HIV-positive patients with poor antiretroviral therapy (ART) adherence. Design: Single-center pilot randomized clinical trial and a nonrandomized control group. Setting: Publicly funded HIV clinic in Atlanta, Georgia, USA. Intervention: The study involved three arms. First, participants in the provider visit incentive (PVI) arm received $30 after attending each scheduled provider visit. Second, participants in the incentive choice arm were given a choice between the above arrangement and a commitment contract that made the $30 payment conditional on both attending the provider visit and meeting an ART adherence threshold. Third, the passive control arm received routine care and no incentives. Participants: A total of 110 HIV-infected adults with a recent plasma HIV-1 viral load more than 200 copies/ml despite ART. The sample sizes of the three groups were as follows: PVI, n=21; incentive choice, n=19; and passive control, n=70. Main outcome measure: Virologic suppression (plasma HIV-1 viral load<=200 copies/ml) at the end of the incentive period and at an unanticipated postincentive study visit approximately three months later. Results: The odds of suppression were higher in the incentive choice arm than in the passive control arm at the postincentive visit (adjusted odds ratio 3.93, 95% confidence interval 1.19–13.04, P=0.025). The differences relative to the passive control arm at the end of the incentive period and relative to the PVI arm at both points in time were not statistically significant. Conclusion: Commitment contracts can improve ART adherence and virologic suppression.en_US
dc.language.isoen_USen_US
dc.publisherOvid Technologies (Wolters Kluwer Health)en_US
dc.relation.isversionofdoi:10.1097/QAD.0000000000001543en_US
dash.licenseOAP
dc.subjecthealth disordersen_US
dc.subjectmotivation and incentivesen_US
dc.titleA Commitment Contract to Achieve Virologic Suppression in Poorly Adherent Patients with HIV/AIDSen_US
dc.typeJournal Articleen_US
dc.date.updated2018-01-17T17:13:49Z
dc.description.versionAccepted Manuscripten_US
dc.relation.journalAIDSen_US
dash.depositing.authorBeshears, John Leonard
dc.date.available2017
dc.date.available2018-06-12T17:36:19Z
dc.identifier.doi10.1097/QAD.0000000000001543*
workflow.legacycommentscat.complete cfr.completeen_US
dash.contributor.affiliatedBeshears, John
dash.contributor.affiliatedMadrian, Brigitte
dash.contributor.affiliatedLaibson, David


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