Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda

Introduction Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness...

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Main Authors: Moses R Kamya, Nolan M Kavanagh, Elisabeth M Schaffer, Alex Ndyabakira, Kara Marson, Diane V Havlir, Dalsone Kwarisiima, Gabriel Chamie, Harsha Thirumurthy
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/5/11/e003390.full
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author Moses R Kamya
Nolan M Kavanagh
Elisabeth M Schaffer
Alex Ndyabakira
Kara Marson
Diane V Havlir
Dalsone Kwarisiima
Gabriel Chamie
Harsha Thirumurthy
author_facet Moses R Kamya
Nolan M Kavanagh
Elisabeth M Schaffer
Alex Ndyabakira
Kara Marson
Diane V Havlir
Dalsone Kwarisiima
Gabriel Chamie
Harsha Thirumurthy
author_sort Moses R Kamya
collection DOAJ
description Introduction Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men.Methods We randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to make a plan to get tested for HIV at health campaigns held in their communities. Participants received either a calendar showing the dates when the community health campaign would be held (control group) or a calendar showing the dates and prompting them to select a date and time when they planned to attend (planning prompt group). Participants were not required to select a date and time or to share their selection with study staff. The primary outcome was HIV testing uptake at the community health campaign.Results Among 2362 participants, 1796 (76%) participants tested for HIV. Men who received a planning prompt were 2.2 percentage points more likely to test than the control group, although the difference was not statistically significant (77.1% vs 74.9%; 95% CI –1.2 to 5.7 percentage points, p=0.20). The planning prompt was more effective among men enrolled ≤40 days before the campaigns (3.6 percentage-point increase in testing; 95% CI –2.9 to 10.1, p=0.27) than among men enrolled >40 days before the campaigns (1.8 percentage-point increase; 95% CI –2.3 to 5.8, p=0.39), although the effects within the subgroups were not significant.Conclusion These findings suggest that planning prompts may be an effective behavioural intervention to promote HIV testing at minimal or no cost. Large-scale studies should further assess the impact and cost-effectiveness of such interventions.
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spelling doaj-art-0c5360df2c75457291ae6d026ae0c0e22025-08-20T02:50:04ZengBMJ Publishing GroupBMJ Global Health2059-79082020-11-0151110.1136/bmjgh-2020-003390Planning prompts to promote uptake of HIV services among men: a randomised trial in rural UgandaMoses R Kamya0Nolan M Kavanagh1Elisabeth M Schaffer2Alex Ndyabakira3Kara Marson4Diane V Havlir5Dalsone Kwarisiima6Gabriel Chamie7Harsha Thirumurthy8Medicine, Makerere University College of Health Sciences, Kampala, UgandaDepartment of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USAData Science to Patient Value, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado, USAInfectious Diseases Research Collaboration, Kampala, Central Region, UgandaDivision of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, California, USADivision of HIV, Infectious Diseases and Global Medicine, University of California San Francisco, San Francisco, California, USAInfectious Diseases Research Collaboration, Kampala, Central Region, UgandaMedicine, University of California, San Francisco, California, USAUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USAIntroduction Interventions informed by behavioural economics, such as planning prompts, have the potential to increase HIV testing at minimal or no cost. Planning prompts have not been previously evaluated for HIV testing uptake. We conducted a randomised clinical trial to evaluate the effectiveness of low-cost planning prompts to promote HIV testing among men.Methods We randomised adult men in rural Ugandan parishes to receive a calendar planning prompt that gave them the opportunity to make a plan to get tested for HIV at health campaigns held in their communities. Participants received either a calendar showing the dates when the community health campaign would be held (control group) or a calendar showing the dates and prompting them to select a date and time when they planned to attend (planning prompt group). Participants were not required to select a date and time or to share their selection with study staff. The primary outcome was HIV testing uptake at the community health campaign.Results Among 2362 participants, 1796 (76%) participants tested for HIV. Men who received a planning prompt were 2.2 percentage points more likely to test than the control group, although the difference was not statistically significant (77.1% vs 74.9%; 95% CI –1.2 to 5.7 percentage points, p=0.20). The planning prompt was more effective among men enrolled ≤40 days before the campaigns (3.6 percentage-point increase in testing; 95% CI –2.9 to 10.1, p=0.27) than among men enrolled >40 days before the campaigns (1.8 percentage-point increase; 95% CI –2.3 to 5.8, p=0.39), although the effects within the subgroups were not significant.Conclusion These findings suggest that planning prompts may be an effective behavioural intervention to promote HIV testing at minimal or no cost. Large-scale studies should further assess the impact and cost-effectiveness of such interventions.https://gh.bmj.com/content/5/11/e003390.full
spellingShingle Moses R Kamya
Nolan M Kavanagh
Elisabeth M Schaffer
Alex Ndyabakira
Kara Marson
Diane V Havlir
Dalsone Kwarisiima
Gabriel Chamie
Harsha Thirumurthy
Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda
BMJ Global Health
title Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda
title_full Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda
title_fullStr Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda
title_full_unstemmed Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda
title_short Planning prompts to promote uptake of HIV services among men: a randomised trial in rural Uganda
title_sort planning prompts to promote uptake of hiv services among men a randomised trial in rural uganda
url https://gh.bmj.com/content/5/11/e003390.full
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