IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v265y2020ics0277953620305529.html
   My bibliography  Save this article

iSAY (incentives for South African youth): Stated preferences of young people living with HIV

Author

Listed:
  • Galárraga, Omar
  • Kuo, Caroline
  • Mtukushe, Bulelwa
  • Maughan-Brown, Brendan
  • Harrison, Abigail
  • Hoare, Jackie

Abstract

High adherence to antiretroviral therapy (ART) is essential for achieving viral suppression and preventing HIV transmission. Yet adherence is suboptimal among adolescents who face unique adherence challenges. Little is known about the role of conditional economic incentives (CEIs) for increasing ART adherence in this population. During 2017–2019, we conducted a mixed-methods discrete choice experiment in Cape Town, South Africa to inform the optimal design of a CEI intervention for ART adherence among youth. In-depth interviews were conducted with n = 35 adolescents (10–19 years old) living with HIV and prescribed ART, to identify attributes of a youth-centered CEI intervention for ART adherence. A discrete choice experiment was subsequently conducted with N = 168 adolescents to elicit preferences for intervention components. A rank-ordered mixed logit model was used for main results; marginal willingness-to-accept (mWTA) was then estimated. Five attributes emerged from the qualitative research as important for a CEI-based intervention for youth ART adherence: (1) incentive amount, (2) incentive format, (3) incentive recipient, (4) delivery mode, and (5) program participants. Youth had a high probability of acceptance of any incentives program (88–100%), yet they did not have a strong preference of a quarterly over a monthly program. From a maximum incentive amount of R1920 (~US$115), youth were willing to forgo up to R126 per year (~US$9) if the incentive was given in cash (versus fashion vouchers); R274 (~US$19.6) if it was open to both previously adherent and non-adherent youth (instead of non-adherent only); and up to R91 (~US$6.5) to receive incentives at a clinic setting (instead of electronically). The use of incentives over the short term during the critical age- and developmental-transition, when adolescents begin to take sole responsibility for their medication-taking behaviors, holds great promise for habituating adherence into adulthood.

Suggested Citation

  • Galárraga, Omar & Kuo, Caroline & Mtukushe, Bulelwa & Maughan-Brown, Brendan & Harrison, Abigail & Hoare, Jackie, 2020. "iSAY (incentives for South African youth): Stated preferences of young people living with HIV," Social Science & Medicine, Elsevier, vol. 265(C).
    • Handle: RePEc:eee:socmed:v:265:y:2020:i:c:s0277953620305529
    DOI: 10.1016/j.socscimed.2020.113333
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953620305529
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2020.113333?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Esther Bekker-Grob & Bas Donkers & Marcel Jonker & Elly Stolk, 2015. "Sample Size Requirements for Discrete-Choice Experiments in Healthcare: a Practical Guide," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 8(5), pages 373-384, October.
    2. Matthew Quaife & Peter Vickerman & Shanthi Manian & Robyn Eakle & Maria A. Cabrera‐Escobar & Sinead Delany‐Moretlwe & Fern Terris‐Prestholt, 2018. "The effect of HIV prevention products on incentives to supply condomless commercial sex among female sex workers in South Africa," Health Economics, John Wiley & Sons, Ltd., vol. 27(10), pages 1550-1566, October.
    3. Marisa Coetzee, 2013. "Finding the Benefits: Estimating the Impact of The South African Child Support Grant," South African Journal of Economics, Economic Society of South Africa, vol. 81(3), pages 427-450, September.
    4. Esther W. de Bekker‐Grob & Mandy Ryan & Karen Gerard, 2012. "Discrete choice experiments in health economics: a review of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 21(2), pages 145-172, February.
    5. Emma L Giles & Frauke Becker & Laura Ternent & Falko F Sniehotta & Elaine McColl & Jean Adams, 2016. "Acceptability of Financial Incentives for Health Behaviours: A Discrete Choice Experiment," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-19, June.
    6. Joanna Coast & Hareth Al‐Janabi & Eileen J. Sutton & Susan A. Horrocks & A. Jane Vosper & Dawn R. Swancutt & Terry N. Flynn, 2012. "Using qualitative methods for attribute development for discrete choice experiments: issues and recommendations," Health Economics, John Wiley & Sons, Ltd., vol. 21(6), pages 730-741, June.
    7. Michaels-Igbokwe, Christine & Lagarde, Mylene & Cairns, John & Terris-Prestholt, Fern, 2014. "Using decision mapping to inform the development of a stated choice survey to elicit youth preferences for sexual and reproductive health and HIV services in rural Malawi," Social Science & Medicine, Elsevier, vol. 105(C), pages 93-102.
    8. Daniel McFadden & Kenneth Train, 2000. "Mixed MNL models for discrete response," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 15(5), pages 447-470.
    9. William T. Harbaugh & Kate Krause & Timothy R. Berry, 2001. "GARP for Kids: On the Development of Rational Choice Behavior," American Economic Review, American Economic Association, vol. 91(5), pages 1539-1545, December.
    10. Juan Carlos C Montoy & William H Dow & Beth C Kaplan, 2018. "Cash incentives versus defaults for HIV testing: A randomized clinical trial," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-10, July.
    11. Emily Lancsar & Joffre Swait, 2014. "Reconceptualising the External Validity of Discrete Choice Experiments," PharmacoEconomics, Springer, vol. 32(10), pages 951-965, October.
    12. Michael Clark & Domino Determann & Stavros Petrou & Domenico Moro & Esther Bekker-Grob, 2014. "Discrete Choice Experiments in Health Economics: A Review of the Literature," PharmacoEconomics, Springer, vol. 32(9), pages 883-902, September.
    13. Train,Kenneth E., 2009. "Discrete Choice Methods with Simulation," Cambridge Books, Cambridge University Press, number 9780521766555, January.
    14. Peter Ghijben & Emily Lancsar & Silva Zavarsek, 2014. "Preferences for Oral Anticoagulants in Atrial Fibrillation: a Best–Best Discrete Choice Experiment," PharmacoEconomics, Springer, vol. 32(11), pages 1115-1127, November.
    15. Martina Björkman Nyqvist & Lucia Corno & Damien de Walque & Jakob Svensson, 2018. "Incentivizing Safer Sexual Behavior: Evidence from a Lottery Experiment on HIV Prevention," American Economic Journal: Applied Economics, American Economic Association, vol. 10(3), pages 287-314, July.
    16. Jennifer A Whitty & Ruth Walker & Xanthe Golenko & Julie Ratcliffe, 2014. "A Think Aloud Study Comparing the Validity and Acceptability of Discrete Choice and Best Worst Scaling Methods," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
    17. David M. Drukker & Richard Gates, 2006. "Generating Halton sequences using Mata," Stata Journal, StataCorp LP, vol. 6(2), pages 214-228, June.
    18. Lohmann, Julia & Muula, Adamson S. & Houlfort, Nathalie & De Allegri, Manuela, 2018. "How does performance-based financing affect health workers' intrinsic motivation? A Self-Determination Theory-based mixed-methods study in Malawi," Social Science & Medicine, Elsevier, vol. 208(C), pages 1-8.
    19. Caroline Vass & Dan Rigby & Katherine Payne, 2017. "The Role of Qualitative Research Methods in Discrete Choice Experiments," Medical Decision Making, , vol. 37(3), pages 298-313, April.
    20. Jan Ostermann & Derek Brown & Axel Mühlbacher & Bernard Njau & Nathan Thielman, 2015. "Would you test for 5000 Shillings? HIV risk and willingness to accept HIV testing in Tanzania," Health Economics Review, Springer, vol. 5(1), pages 1-11, December.
    21. Mandy Ryan & Karen Gerard & Gillian Currie, 2012. "Using Discrete Choice Experiments in Health Economics," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 41, Edward Elgar Publishing.
    22. Emily Lancsar & Denzil G. Fiebig & Arne Risa Hole, 2017. "Discrete Choice Experiments: A Guide to Model Specification, Estimation and Software," PharmacoEconomics, Springer, vol. 35(7), pages 697-716, July.
    23. Nancy L Czaicki & William H Dow & Prosper F Njau & Sandra I McCoy, 2018. "Do incentives undermine intrinsic motivation? Increases in intrinsic motivation within an incentive-based intervention for people living with HIV in Tanzania," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-15, June.
    24. Mandy Ryan & Verity Watson & Vikki Entwistle, 2009. "Rationalising the ‘irrational’: a think aloud study of discrete choice experiment responses," Health Economics, John Wiley & Sons, Ltd., vol. 18(3), pages 321-336, March.
    25. J. M. Gibson & D. Rigby & D. A. Polya & N. Russell, 2016. "Discrete Choice Experiments in Developing Countries: Willingness to Pay Versus Willingness to Work," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 65(4), pages 697-721, December.
    26. Fredrik Carlsson & Peter Martinsson, 2003. "Design techniques for stated preference methods in health economics," Health Economics, John Wiley & Sons, Ltd., vol. 12(4), pages 281-294, April.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Buckell, John & Hess, Stephane, 2019. "Stubbing out hypothetical bias: improving tobacco market predictions by combining stated and revealed preference data," Journal of Health Economics, Elsevier, vol. 65(C), pages 93-102.
    2. Nicolas Krucien & Jonathan Sicsic & Mandy Ryan, 2019. "For better or worse? Investigating the validity of best–worst discrete choice experiments in health," Health Economics, John Wiley & Sons, Ltd., vol. 28(4), pages 572-586, April.
    3. Genie, Mesfin G. & Ryan, Mandy & Krucien, Nicolas, 2021. "To pay or not to pay? Cost information processing in the valuation of publicly funded healthcare," Social Science & Medicine, Elsevier, vol. 276(C).
    4. Chandoevwit, Worawan & Wasi, Nada, 2020. "Incorporating discrete choice experiments into policy decisions: Case of designing public long-term care insurance," Social Science & Medicine, Elsevier, vol. 258(C).
    5. Mandy Ryan & Nicolas Krucien & Frouke Hermens, 2018. "The eyes have it: Using eye tracking to inform information processing strategies in multi‐attributes choices," Health Economics, John Wiley & Sons, Ltd., vol. 27(4), pages 709-721, April.
    6. Haghani, Milad & Bliemer, Michiel C.J. & Hensher, David A., 2021. "The landscape of econometric discrete choice modelling research," Journal of choice modelling, Elsevier, vol. 40(C).
    7. de Bekker-Grob, E.W. & Donkers, B. & Bliemer, M.C.J. & Veldwijk, J. & Swait, J.D., 2020. "Can healthcare choice be predicted using stated preference data?," Social Science & Medicine, Elsevier, vol. 246(C).
    8. Kaat de Corte & John Cairns & Richard Grieve, 2021. "Stated versus revealed preferences: An approach to reduce bias," Health Economics, John Wiley & Sons, Ltd., vol. 30(5), pages 1095-1123, May.
    9. Milte, Rachel & Huynh, Elisabeth & Ratcliffe, Julie, 2019. "Assessing quality of care in nursing homes using discrete choice experiments: How does the level of cognitive functioning impact upon older people's preferences?," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    10. Robert J. Johnston & Kevin J. Boyle & Wiktor (Vic) Adamowicz & Jeff Bennett & Roy Brouwer & Trudy Ann Cameron & W. Michael Hanemann & Nick Hanley & Mandy Ryan & Riccardo Scarpa & Roger Tourangeau & Ch, 2017. "Contemporary Guidance for Stated Preference Studies," Journal of the Association of Environmental and Resource Economists, University of Chicago Press, vol. 4(2), pages 319-405.
    11. Viberg Johansson, Jennifer & Shah, Nisha & Haraldsdóttir, Eik & Bentzen, Heidi Beate & Coy, Sarah & Kaye, Jane & Mascalzoni, Deborah & Veldwijk, Jorien, 2021. "Governance mechanisms for sharing of health data: An approach towards selecting attributes for complex discrete choice experiment studies," Technology in Society, Elsevier, vol. 66(C).
    12. Joachim Marti & John Buckell & Johanna Catherine Maclean & Jody L. Sindelar, 2016. "To ‘Vape’ or Smoke? A Discrete Choice Experiment Among U.S. Adult Smokers," NBER Working Papers 22079, National Bureau of Economic Research, Inc.
    13. Osborne, Matthew & Lambe, Fiona & Ran, Ylva & Dehmel, Naira & Tabacco, Giovanni Alberto & Balungira, Joshua & Pérez-Viana, Borja & Widmark, Erik & Holmlid, Stefan & Verschoor, Arjan, 2022. "Designing development interventions: The application of service design and discrete choice experiments in complex settings," World Development, Elsevier, vol. 158(C).
    14. Emily Lancsar & Peter Burge, 2014. "Choice modelling research in health economics," Chapters, in: Stephane Hess & Andrew Daly (ed.), Handbook of Choice Modelling, chapter 28, pages 675-687, Edward Elgar Publishing.
    15. Oedingen, Carina & Bartling, Tim & Schrem, Harald & Mühlbacher, Axel C. & Krauth, Christian, 2021. "Public preferences for the allocation of donor organs for transplantation: A discrete choice experiment," Social Science & Medicine, Elsevier, vol. 287(C).
    16. Mesfin G. Genie & Nicolas Krucien & Mandy Ryan, 2021. "Weighting or aggregating? Investigating information processing in multi‐attribute choices," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1291-1305, June.
    17. Nikita Arora & Matthew Quaife & Kara Hanson & Mylene Lagarde & Dorka Woldesenbet & Abiy Seifu & Romain Crastes dit Sourd, 2022. "Discrete choice analysis of health worker job preferences in Ethiopia: Separating attribute non‐attendance from taste heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 806-819, May.
    18. Chen, Gang & Ratcliffe, Julie & Milte, Rachel & Khadka, Jyoti & Kaambwa, Billingsley, 2021. "Quality of care experience in aged care: An Australia-Wide discrete choice experiment to elicit preference weights," Social Science & Medicine, Elsevier, vol. 289(C).
    19. John Buckell & Vrinda Vasavada & Sarah Wordsworth & Dean A. Regier & Matthew Quaife, 2022. "Utility maximization versus regret minimization in health choice behavior: Evidence from four datasets," Health Economics, John Wiley & Sons, Ltd., vol. 31(2), pages 363-381, February.
    20. Huls, Samare P.I. & de Bekker-Grob, Esther W., 2022. "Can healthcare choice be predicted using stated preference data? The role of model complexity in a discrete choice experiment about colorectal cancer screening," Social Science & Medicine, Elsevier, vol. 315(C).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:265:y:2020:i:c:s0277953620305529. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.