IDEAS home Printed from https://ideas.repec.org/a/spr/eujhec/v26y2025i2d10.1007_s10198-024-01705-y.html
   My bibliography  Save this article

Incentivizing adherence to pre-exposure prophylaxis for HIV prevention: a randomized pilot trial among male sex workers in Mexico

Author

Listed:
  • Omar Galárraga

    (Brown University School of Public Health
    Brown University School of Public Health)

  • Marta Wilson-Barthes

    (Brown University School of Public Health)

  • Carlos Chivardi

    (National Institute of Public Health (INSP)
    University of York)

  • Nathalie Gras-Allain

    (Clínica Especializada Condesa)

  • Fernando Alarid-Escudero

    (Center for Economics Teaching and Research (CIDE)
    Stanford University School of Medicine)

  • Monica Gandhi

    (University of California)

  • Kenneth H. Mayer

    (The Fenway Institute
    Harvard T.H. Chan School of Public Health)

  • Don Operario

    (Emory University)

Abstract

Low adherence to preventative medications against life-long health conditions is a major contributor to global morbidity and mortality. We implemented a pilot randomized controlled trial in Mexico to measure the extent to which conditional economic incentives help male sex workers increase their adherence to pre-exposure prophylaxis (PrEP) for HIV prevention. We followed n = 110 male sex workers over 6 months. At each quarterly visit (at months 0, 3, and 6), all workers received a $10 transport reimbursement, a free 3-month PrEP supply, and completed socio-behavioral surveys. The primary outcome was an objective biomarker of medication adherence based on tenofovir (TFV) drug concentration levels in hair collected at each visit. Individuals randomized to the intervention received incentives based on a grading system as a function of PrEP adherence: those with high (> 0.043 ng/mg TFV concentration), medium (0.011 to 0.042 ng/mg), or low (

Suggested Citation

  • Omar Galárraga & Marta Wilson-Barthes & Carlos Chivardi & Nathalie Gras-Allain & Fernando Alarid-Escudero & Monica Gandhi & Kenneth H. Mayer & Don Operario, 2025. "Incentivizing adherence to pre-exposure prophylaxis for HIV prevention: a randomized pilot trial among male sex workers in Mexico," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 26(2), pages 299-311, March.
  • Handle: RePEc:spr:eujhec:v:26:y:2025:i:2:d:10.1007_s10198-024-01705-y
    DOI: 10.1007/s10198-024-01705-y
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10198-024-01705-y
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s10198-024-01705-y?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

    for a different version of it.

    References listed on IDEAS

    as
    1. Wei Pan, 2001. "Akaike's Information Criterion in Generalized Estimating Equations," Biometrics, The International Biometric Society, vol. 57(1), pages 120-125, March.
    2. Packel, Laura J. & de Walque, Damien & Feeney, Kevin C. & Balampama, Marianna P. & Cooper, Jan E. & Kalolella, Admirabilis & Wechsberg, Wendee M. & Dow, William H., 2021. "A randomized trial of cash incentives for sexual behavior change among female sex workers in Dar es Salaam," Social Science & Medicine, Elsevier, vol. 272(C).
    3. 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.
    4. repec:plo:pone00:0188393 is not listed on IDEAS
    5. Pascaline Dupas, 2014. "Short‐Run Subsidies and Long‐Run Adoption of New Health Products: Evidence From a Field Experiment," Econometrica, Econometric Society, vol. 82(1), pages 197-228, January.
    6. Henrique Pereira, 2021. "Male Sex Workers Selling Physical Sex during the COVID-19 Pandemic in Portugal: Motives, Safer Sex Practices, and Social Vulnerabilities," Societies, MDPI, vol. 11(4), pages 1-13, September.
    7. de Walque, Damien & Dow, William H & Nathan, Rose & Abdul, Ramadhani & Abilahi, Faraji & Gong, Erick & Isdahl, Zachary & Jamison, Julian & Jullu, Boniphace & Krishnan, Suneeta & Majura, Albert & Migue, 2012. "Incentivising safe sex: a randomised trial of conditional cash transfers for HIV and sexually transmitted infection prevention in rural Tanzania," Department of Economics, Working Paper Series qt4vw984q0, Department of Economics, Institute for Business and Economic Research, UC Berkeley.
    8. James Cui, 2007. "QIC program and model selection in GEE analyses," Stata Journal, StataCorp LLC, vol. 7(2), pages 209-220, June.
    9. Omar Galárraga & Sebastian Linnemayr & Sandra I. McCoy & Harsha Thirumurthy & Christopher Gordon & Susan Vorkoper, 2023. "We must invest in behavioural economics for the HIV response," Nature Human Behaviour, Nature, vol. 7(8), pages 1241-1244, August.
    10. de Walque, Damien, 2020. "The use of financial incentives to prevent unhealthy behaviors: A review," Social Science & Medicine, Elsevier, vol. 261(C).
    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. Aristides dos Santos, Anderson Moreira & Perelman, Julian & Jacinto, Paulo de Andrade & Tejada, Cesar Augusto Oviedo & Barros, Aluísio J.D. & Bertoldi, Andréa D. & Matijasevich, Alicia & Santos, Iná S, 2019. "Income-related inequality and inequity in children’s health care: A longitudinal analysis using data from Brazil," Social Science & Medicine, Elsevier, vol. 224(C), pages 127-137.
    2. Fischer, Caroline & Schott, Carina, 2020. "Why People Enter and Stay in Public Service Careers: The Role of Parental Socialization and an Interest in Politics," OSF Preprints yb8e3, Center for Open Science.
    3. Irina Chis Ster & Hamzah F Niaz & Martha E Chico & Yisela Oviedo & Maritza Vaca & Philip J Cooper, 2021. "The epidemiology of soil-transmitted helminth infections in children up to 8 years of age: Findings from an Ecuadorian birth cohort," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 15(11), pages 1-20, November.
    4. D. T. Nava & F. De Bastiani & M. A. Uribe-Opazo & O. Nicolis & M. Galea, 2017. "Local Influence for Spatially Correlated Binomial Data: An Application to the Spodoptera frugiperda Infestation in Corn," Journal of Agricultural, Biological and Environmental Statistics, Springer;The International Biometric Society;American Statistical Association, vol. 22(4), pages 540-561, December.
    5. Maximilian Goethner & Sebastian Luettig & Tobias Regner, 2021. "Crowdinvesting in entrepreneurial projects: disentangling patterns of investor behavior," Small Business Economics, Springer, vol. 57(2), pages 905-926, August.
    6. Gregory N. Price & Juliet U. Elu, 2014. "Does regional currency integration ameliorate global macroeconomic shocks in sub-Saharan Africa? The case of the 2008-2009 global financial crisis," Journal of Economic Studies, Emerald Group Publishing Limited, vol. 41(5), pages 737-750, September.
    7. Xiao Hu & Yang Wang & Jidong Huang & Rong Zheng, 2019. "Cigarette Affordability and Cigarette Consumption among Adult and Elderly Chinese Smokers: Evidence from A Longitudinal Study," IJERPH, MDPI, vol. 16(23), pages 1-20, December.
    8. Justin George, 2018. "State Failure and Transnational Terrorism," Journal of Conflict Resolution, Peace Science Society (International), vol. 62(3), pages 471-495, March.
    9. María Carmen Pardo & Rosa Alonso, 2019. "Working correlation structure selection in GEE analysis," Statistical Papers, Springer, vol. 60(5), pages 1447-1467, October.
    10. Laing, Timothy, 2015. "Rights to the forest, REDD+ and elections: Mining in Guyana," Resources Policy, Elsevier, vol. 46(P2), pages 250-261.
    11. repec:osf:osfxxx:yb8e3_v1 is not listed on IDEAS
    12. Albert Wong & Pieter H. M. van Baal & Hendriek C. Boshuizen & Johan J. Polder, 2011. "Exploring the influence of proximity to death on disease‐specific hospital expenditures: a carpaccio of red herrings," Health Economics, John Wiley & Sons, Ltd., vol. 20(4), pages 379-400, April.
    13. Peter Bergman, 2020. "Nudging Technology Use: Descriptive and Experimental Evidence from School Information Systems," Education Finance and Policy, MIT Press, vol. 15(4), pages 623-647, Fall.
    14. Raphaël Soubeyran, 2019. "Technology adoption and pro-social preferences," CEE-M Working Papers halshs-02291905, CEE-M, Universtiy of Montpellier, CNRS, INRA, Montpellier SupAgro.
    15. Omar Galárraga & Sandra Sosa-Rubí & César Infante & Paul Gertler & Stefano Bertozzi, 2014. "Willingness-to-accept reductions in HIV risks: conditional economic incentives in Mexico," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 41-55, January.
    16. Adhvaryu, Achyuta, 2011. "Learning, Misallocation, and Technology Adoption: Evidence from New Malaria Therapy in Tanzania," Center Discussion Papers 115712, Yale University, Economic Growth Center.
    17. Wei Pan, 2001. "Model Selection in Estimating Equations," Biometrics, The International Biometric Society, vol. 57(2), pages 529-534, June.
    18. B Kelsey Jack, "undated". "Market Inefficiencies and the Adoption of Agricultural Technologies in Developing Countries," CID Working Papers 50, Center for International Development at Harvard University.
    19. Hoffmann, Bridget, 2018. "Do non-monetary prices target the poor? Evidence from a field experiment in India," Journal of Development Economics, Elsevier, vol. 133(C), pages 15-32.
    20. Szmaragd, Camille & Clarke, Paul & Steele, Fiona, 2013. "Subject specific and population average models for binary longitudinal data: a tutorial," LSE Research Online Documents on Economics 52199, London School of Economics and Political Science, LSE Library.
    21. Victor Iajya & Nicola Lacetera & Mario Macis & Robert Slonim, 2012. "The Effects of Information, Social and Economic Incentives on Voluntary Undirected Blood Donations: Evidence from a Randomized Controlled Trial in Argentina," NBER Working Papers 18630, National Bureau of Economic Research, Inc.

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    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:spr:eujhec:v:26:y:2025:i:2:d:10.1007_s10198-024-01705-y. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.