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Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda
BACKGROUND: Few studies have explored how economic incentives influence behavioral outcomes. This study aimed to identify pathways of action of an incentives-based intervention to increase men’s participation in HIV testing. METHODS: The qualitative study was embedded in a randomized-controlled tria...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937741/ https://www.ncbi.nlm.nih.gov/pubmed/31888589 http://dx.doi.org/10.1186/s12889-019-8073-6 |
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author | Ndyabakira, Alex Getahun, Monica Byamukama, Ambrose Emperador, Devy Kabageni, Stella Marson, Kara Kwarisiima, Dalsone Chamie, Gabriel Thirumurthy, Harsha Havlir, Diane Kamya, Moses R. Camlin, Carol S. |
author_facet | Ndyabakira, Alex Getahun, Monica Byamukama, Ambrose Emperador, Devy Kabageni, Stella Marson, Kara Kwarisiima, Dalsone Chamie, Gabriel Thirumurthy, Harsha Havlir, Diane Kamya, Moses R. Camlin, Carol S. |
author_sort | Ndyabakira, Alex |
collection | PubMed |
description | BACKGROUND: Few studies have explored how economic incentives influence behavioral outcomes. This study aimed to identify pathways of action of an incentives-based intervention to increase men’s participation in HIV testing. METHODS: The qualitative study was embedded in a randomized-controlled trial that compared effectiveness of gain-framed, loss-framed and lottery-based incentives to increase HIV testing among men. Following testing at a community health campaign, 60 in-depth interviews were conducted with men systematically sampled on the basis of age, incentive group, and campaign attendance. Data were coded deductively and inductively for thematic content analysis. RESULTS: Incentives addressed men’s structural, interpersonal and individual-level barriers to testing: offered at convenient locations, incentives offset costs of testing, in lost wages, which are exacerbated when livelihoods required mobility. Interpersonal barriers included anticipated stigma/fear of disclosure, social obligations, and negative peer influences. Providing incentives in public settings provided “social proof” that prizes could be won, and facilitated social support and positive norms by promoting testing with trusted others. Incentives had little influence when men appraised prize values to be low, disbelieved they would win a prize, or were already intrinsically motivated to test. Yet, incentives provided a behavioral ‘cue to action’ for many men who perceived themselves to be susceptible to HIV and perceived HIV disease to be severe, acting as secondary motivator for testing that “sweetened the deal”. CONCLUSION: Incentives can be an important ‘lever’ to promote men’s healthy behaviors in resource-poor settings. HIV testing in convenient, public settings, when paired with incentives, provides multiple pathways to stimulate men’s testing uptake. TRIAL REGISTRATION: Registered with ClinicalTrials.gov on 08/10/2016, ID: NCT02890459. The first participant was enrolled on 11th April 2016. |
format | Online Article Text |
id | pubmed-6937741 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-69377412019-12-31 Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda Ndyabakira, Alex Getahun, Monica Byamukama, Ambrose Emperador, Devy Kabageni, Stella Marson, Kara Kwarisiima, Dalsone Chamie, Gabriel Thirumurthy, Harsha Havlir, Diane Kamya, Moses R. Camlin, Carol S. BMC Public Health Research Article BACKGROUND: Few studies have explored how economic incentives influence behavioral outcomes. This study aimed to identify pathways of action of an incentives-based intervention to increase men’s participation in HIV testing. METHODS: The qualitative study was embedded in a randomized-controlled trial that compared effectiveness of gain-framed, loss-framed and lottery-based incentives to increase HIV testing among men. Following testing at a community health campaign, 60 in-depth interviews were conducted with men systematically sampled on the basis of age, incentive group, and campaign attendance. Data were coded deductively and inductively for thematic content analysis. RESULTS: Incentives addressed men’s structural, interpersonal and individual-level barriers to testing: offered at convenient locations, incentives offset costs of testing, in lost wages, which are exacerbated when livelihoods required mobility. Interpersonal barriers included anticipated stigma/fear of disclosure, social obligations, and negative peer influences. Providing incentives in public settings provided “social proof” that prizes could be won, and facilitated social support and positive norms by promoting testing with trusted others. Incentives had little influence when men appraised prize values to be low, disbelieved they would win a prize, or were already intrinsically motivated to test. Yet, incentives provided a behavioral ‘cue to action’ for many men who perceived themselves to be susceptible to HIV and perceived HIV disease to be severe, acting as secondary motivator for testing that “sweetened the deal”. CONCLUSION: Incentives can be an important ‘lever’ to promote men’s healthy behaviors in resource-poor settings. HIV testing in convenient, public settings, when paired with incentives, provides multiple pathways to stimulate men’s testing uptake. TRIAL REGISTRATION: Registered with ClinicalTrials.gov on 08/10/2016, ID: NCT02890459. The first participant was enrolled on 11th April 2016. BioMed Central 2019-12-30 /pmc/articles/PMC6937741/ /pubmed/31888589 http://dx.doi.org/10.1186/s12889-019-8073-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Ndyabakira, Alex Getahun, Monica Byamukama, Ambrose Emperador, Devy Kabageni, Stella Marson, Kara Kwarisiima, Dalsone Chamie, Gabriel Thirumurthy, Harsha Havlir, Diane Kamya, Moses R. Camlin, Carol S. Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda |
title | Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda |
title_full | Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda |
title_fullStr | Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda |
title_full_unstemmed | Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda |
title_short | Leveraging incentives to increase HIV testing uptake among men: qualitative insights from rural Uganda |
title_sort | leveraging incentives to increase hiv testing uptake among men: qualitative insights from rural uganda |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937741/ https://www.ncbi.nlm.nih.gov/pubmed/31888589 http://dx.doi.org/10.1186/s12889-019-8073-6 |
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