Optimizing the Efficiency and Implementation of Cash Transfers to Improve Adherence to Antiretroviral Therapy

Study Overview
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Brief Summary
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Determine the dose-response relationship between a cash transfer amount and HIV viral suppression at 6 months Identify the most effective cash transfer size to increase the proportion of people living with HIV infection (PLHIV) retained in care and with suppressed viral load (<1000 copies/ml) after 6 months. (This amount will be further evaluated in a cluster randomized trial in Phase 2).

Detailed Description
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Participants in the control group will receive the standard HIV primary care services according to Tanzania's National Guidelines for the Management of HIV and AIDS. The study has two active intervention arms: The opportunity to earn 10,000 TZS/month ( $4.50) for up to 6 months conditional on visit attendance, and The opportunity to earn 22,500 TZS/month ( $10.00) for up to 6 months conditional on visit attendance In both intervention arms, cash transfers will be delivered a maximum of once monthly, spaced ≥28 days apart, for up to six months and delivered via an automatic mobile money system linked to a biometric identification system.

Official Title
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Optimizing the Efficiency and Implementation of Cash Transfers to Improve Adherence to Antiretroviral Therapy

Conditions
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HIV/AIDS, Adherence, Medication, Adherence, Patient

Intervention / Treatment
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* Behavioral: Active Arm 1
* Behavioral: Active Arm 2


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥18 years Living with HIV infection Initiated antiretroviral therapy ≤1 month prior to enrollment in the study Exclusion Criteria: - Participants who do no provide informed consent

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Comparison Arm<br>Participants in the comparison group will receive the standard HIV primary care services according to Tanzania's National Guidelines for the Management of HIV and AIDS. | |
| Experimental: Active Intervention 1<br>Participants will receive the standard HIV primary care services according to Tanzania's National Guidelines for the Management of HIV and AIDS plus the opportunity to earn 10,000 TZS/month ( $4.50) for up to 6 months conditional on visit attendance. | Behavioral: Active Arm 1<br>* Participants in this arm will receive the standard HIV primary care services according to Tanzania's National Guidelines for the Management of HIV and AIDS plus the opportunity to earn 10,000 TZS/month conditional on visit attendance.<br>|
| Experimental: Active Intervention 2<br>Participants will receive the standard HIV primary care services according to Tanzania's National Guidelines for the Management of HIV and AIDS plus the opportunity to earn 22,500 TZS/month ( $10.00) for up to 6 months conditional on visit attendance. | Behavioral: Active Arm 2<br>* Participants in this arm will receive the standard HIV primary care services according to Tanzania's National Guidelines for the Management of HIV and AIDS plus the opportunity to earn 22,500 TZS/month conditional on visit attendance.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| HIV viral suppression at 6 months | <1000 copies/ml | 6 months |