@article{5b6a5865e99741fe9d8fcd1c81223ac7,
title = "Using Incentives and Nudging to Improve Non-Targeted HIV Testing in Ecuador: A Randomized Trial",
abstract = "Under-detection of HIV/AIDS still burdens many low- and middle-income countries (LMICs). Our randomized trial investigated the effects of financial incentives and a behavioral nudge to induce HIV testing and learning HIV status in Ecuador. In the control group, 12.2% of participants agreed to testing, and 5.3% learned results. A financial incentive paid at testing increased the fraction of participants tested by 50.1 percentage points (95% CI 38.8 to 61.4) and the fraction who learned their status by 8.9 percentage points (95% CI 5.3 to 12.5); the nudge had no effect. The HIV-positive rate was 1.2% in the control group, and incentives prompted a 4.7 percentage point (95% CI 0.5 to 8.9) higher proportion of HIV-positive detection. Incentives also induced earlier testing, suggesting reduced procrastination. This suggests that information with appropriately timed small financial incentives can improve HIV testing and detection of new cases in the general population in LMIC settings.",
keywords = "Behavioral nudges, Cost analysis, Ecuador, Ethnic minority, HIV, Incentives, Testing",
author = "Mario Macis and Michelle Grunauer and Erika Gutierrez and Ricardo Izurieta and Phillip Phan and {Reina Ortiz}, Miguel and Carlos Rosas and Enrique Teran",
note = "Funding Information: We are grateful to the Creative and Novel Ideas in HIV Research (CNIHR) leadership and to 2017 and 2018 CNIHR workshop participants for valuable comments and support. We gratefully acknowledge the support of the Municipality of Esmeraldas, especially Mayor Lenin Lara, and Council Member Rubin Perea. We thank Adriana Elba Campos for excellent research assistance, and Sheronda Gordon for outstanding administrative support. We are especially grateful to Dr. Diogenes Cuero Caicedo and his team at the Fundacion Raices. Dr. Cuero Caicedo passed away prematurely in January 2019. He will be missed by many in his community of Esmeraldas. This article is dedicated to his memory. Funding Information: We are grateful to the Creative and Novel Ideas in HIV Research (CNIHR) leadership and to 2017 and 2018 CNIHR workshop participants for valuable comments and support. We gratefully acknowledge the support of the Municipality of Esmeraldas, especially Mayor Lenin Lara, and Council Member Rubin Perea. We thank Adriana Elba Campos for excellent research assistance, and Sheronda Gordon for outstanding administrative support. We are especially grateful to Dr. Diogenes Cuero Caicedo and his team at the Fundacion Raices. Dr. Cuero Caicedo passed away prematurely in January 2019. He will be missed by many in his community of Esmeraldas. This article is dedicated to his memory. Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",
year = "2021",
month = aug,
doi = "10.1007/s10461-021-03215-x",
language = "English (US)",
volume = "25",
pages = "2542--2550",
journal = "AIDS and behavior",
issn = "1090-7165",
publisher = "Springer New York",
number = "8",
}