Incentives for Viral Suppression in People Living with HIV: A Randomized Clinical Trial

Kenneth Silverman, August F. Holtyn, Andrew M. Rodewald, Robert F. Siliciano, Brantley P. Jarvis, Shrinidhi Subramaniam, Jeannie Marie Leoutsakos, Carol Ann Getty, Sebastian Ruhs, Mark A. Marzinke, Michael Fingerhood

Research output: Contribution to journalArticlepeer-review


The HIV/AIDS epidemic can be eliminated if 73% of people living with HIV take antiretroviral medications and achieve undetectable viral loads. This study assessed the effects of financial incentives in suppressing viral load. People living with HIV with detectable viral loads (N = 102) were randomly assigned to Usual Care or Incentive groups. Incentive participants earned up to $10 per day for 2 years for providing blood samples that showed either reduced or undetectable viral loads. This report presents data on the 1st year after random assignment. Incentive participants provided more (adjusted OR = 15.6, CI 4.2–58.8, p < 0.001) blood samples at 3-month assessments with undetectable viral load (72.1%) than usual care control participants (39.0%). We collected most blood samples. The study showed that incentives can substantially increase undetectable viral loads in people living with HIV. Financial incentives for suppressed viral loads could contribute to the eradication of the HIV/AIDS epidemic.

Original languageEnglish (US)
Pages (from-to)2337-2346
Number of pages10
JournalAIDS and behavior
Issue number9
StatePublished - Sep 1 2019


  • ART
  • Antiretroviral medication adherence
  • HIV
  • Incentives
  • Viral suppression

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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