Marcel Yotebieng1, Kathryn E Moracco, Harsha Thirumurthy, Andrew Edmonds, Martine Tabala, Bienvenu Kawende, Landry K Wenzi, Emile W Okitolonda, Frieda Behets. 1. *Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH; Departments of †Epidemiology; ‡Health Behavior; §Health Policy and Management, The University of North Carolina at Chapel Hill, Chapel Hill, NC; ‖School of Public Health, The University of Kinshasa, Kinshasa, Democratic Republic of Congo; and ¶Department of Social Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract
OBJECTIVE: To elucidate the mechanisms by which a cash incentive intervention increases retention in prevention of mother-to-child transmission services. METHODS: We used data from a randomized controlled trial in Kinshasa, Democratic Republic of Congo. Perceptual factors associated with loss to follow-up (LTFU) through 6 weeks postpartum were first identified. Then, binomial models were used to assess interactions between LTFU and identified factors, and the cash incentive intervention. RESULTS: Participants were less likely to be LTFU if they perceived HIV as a "very serious" health problem for their baby vs. not [risk difference (RD), -0.13; 95% confidence interval (CI): -0.30 to 0.04], if they believed it would be "very likely" to pass HIV to their baby if they did not take any HIV drug vs. not (RD, -0.15; 95% CI: -0.32 to 0.02), and if they anticipated that not having money would make it difficult for them to come to the clinic vs. not (RD, 0.12; 95% CI: -0.07 to 0.30). The effect of each of the 3 factors on LTFU was antagonistic to that of receiving the cash incentive intervention. The excess risk due to interaction between the cash incentive intervention and the anticipated difficulty of "not having money" to come to the clinic was exactly equal to the effect of removing this perceived barrier (excess risk due to interaction, -0.12; 95% CI: -0.35 to 0.10). CONCLUSIONS: Our analyses show that cash transfers improve retention in prevention of mother-to-child transmission services mainly by mitigating the negative effect of not having money to come to the clinic.
RCT Entities:
OBJECTIVE: To elucidate the mechanisms by which a cash incentive intervention increases retention in prevention of mother-to-child transmission services. METHODS: We used data from a randomized controlled trial in Kinshasa, Democratic Republic of Congo. Perceptual factors associated with loss to follow-up (LTFU) through 6 weeks postpartum were first identified. Then, binomial models were used to assess interactions between LTFU and identified factors, and the cash incentive intervention. RESULTS:Participants were less likely to be LTFU if they perceived HIV as a "very serious" health problem for their baby vs. not [risk difference (RD), -0.13; 95% confidence interval (CI): -0.30 to 0.04], if they believed it would be "very likely" to pass HIV to their baby if they did not take any HIV drug vs. not (RD, -0.15; 95% CI: -0.32 to 0.02), and if they anticipated that not having money would make it difficult for them to come to the clinic vs. not (RD, 0.12; 95% CI: -0.07 to 0.30). The effect of each of the 3 factors on LTFU was antagonistic to that of receiving the cash incentive intervention. The excess risk due to interaction between the cash incentive intervention and the anticipated difficulty of "not having money" to come to the clinic was exactly equal to the effect of removing this perceived barrier (excess risk due to interaction, -0.12; 95% CI: -0.35 to 0.10). CONCLUSIONS: Our analyses show that cash transfers improve retention in prevention of mother-to-child transmission services mainly by mitigating the negative effect of not having money to come to the clinic.
Authors: Elizabeth M Stringer; Benjamin H Chi; Namwinga Chintu; Tracy L Creek; Didier K Ekouevi; David Coetzee; Pius Tih; Andrew Boulle; Francois Dabis; Nathan Shaffer; Catherine M Wilfert; Jeffrey S A Stringer Journal: Bull World Health Organ Date: 2008-01 Impact factor: 9.408
Authors: Ziad El-Khatib; Anna Mia Ekstrom; Ashraf Coovadia; Elaine J Abrams; Max Petzold; David Katzenstein; Lynn Morris; Louise Kuhn Journal: BMC Public Health Date: 2011-02-08 Impact factor: 3.295
Authors: Alemnesh H Mirkuzie; Sven Gudmund Hinderaker; Mitike Molla Sisay; Karen Marie Moland; Odd Mørkve Journal: J Int AIDS Soc Date: 2011-10-21 Impact factor: 5.396
Authors: Bryna J Harrington; Brian W Pence; Madalitso Maliwichi; Allan N Jumbe; Ntchindi A Gondwe; Shaphil D Wallie; Bradley N Gaynes; Joanna Maselko; William C Miller; Mina C Hosseinipour Journal: AIDS Date: 2018-11-28 Impact factor: 4.177
Authors: Wafaa M El-Sadr; Deborah Donnell; Geetha Beauchamp; H Irene Hall; Lucia V Torian; Barry Zingman; Garret Lum; Michael Kharfen; Richard Elion; Jason Leider; Fred M Gordin; Vanessa Elharrar; David Burns; Allison Zerbe; Theresa Gamble; Bernard Branson Journal: JAMA Intern Med Date: 2017-08-01 Impact factor: 21.873
Authors: S Carlos; E Burgueño; A Ndarabu; G Reina; C Lopez-Del Burgo; A Osorio; B Makonda; J de Irala Journal: Sci Rep Date: 2021-03-08 Impact factor: 4.379