The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysis
Abstract Background Achieving and maintaining viral suppression and optimal adherence to antiretroviral therapy are crucial for improving health outcomes in general population of people living with HIV. This study aimed to evaluate the effects of monetary incentives on these key treatment goals. Met...
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2025-06-01
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| Series: | AIDS Research and Therapy |
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| Online Access: | https://doi.org/10.1186/s12981-025-00748-2 |
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| author | Zhihong Zhu Liangyou Guo Maoxian Yang Junya Cheng |
| author_facet | Zhihong Zhu Liangyou Guo Maoxian Yang Junya Cheng |
| author_sort | Zhihong Zhu |
| collection | DOAJ |
| description | Abstract Background Achieving and maintaining viral suppression and optimal adherence to antiretroviral therapy are crucial for improving health outcomes in general population of people living with HIV. This study aimed to evaluate the effects of monetary incentives on these key treatment goals. Methods We conducted a systematic review and meta-analysis, searching the Cochrane Library, Medline, EMBASE, CINAHL, Web of Science, and Scopus databases from inception to March 2025. We included randomized controlled trials comparing monetary incentives with routine care in people living with HIV. The primary outcomes were viral suppression and adherence to antiretroviral therapy. Random-effects meta-analyses were used to calculate pooled odds ratios with 95% confidence intervals. This study was registered with PROSPERO (registration number CRD42024524374). Results Thirteen randomized controlled trials were included. Compared with routine care, monetary incentives significantly improved viral suppression (OR = 1.39,95%CI: 1.11, 1.74); p = 0.004; I²=42%), adherence to antiretroviral therapy (OR = 1.62,95%CI: 1.13,2.31; p = 0.008; I²=30%) and retention in care (OR = 1.27, 95% CI: 1.02–1.57; p = 0.03; I²=9%). The difference in CD4 + T-cell counts between groups did not reach statistical significance (SMD = -38.90, 95% CI: -77.35 to -0.45; p = 0.05), with low heterogeneity (I² = 28%). Conclusion Monetary incentives effectively improve viral suppression and adherence to antiretroviral therapy among people living with HIV. Integrating monetary incentives into HIV care models could be a promising strategy to optimize treatment outcomes. Further research is needed to assess the long-term sustainability and cost-effectiveness of such interventions. |
| format | Article |
| id | doaj-art-5bb61fe6ebde4660a932c03bd734629c |
| institution | DOAJ |
| issn | 1742-6405 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | AIDS Research and Therapy |
| spelling | doaj-art-5bb61fe6ebde4660a932c03bd734629c2025-08-20T03:10:32ZengBMCAIDS Research and Therapy1742-64052025-06-0122111410.1186/s12981-025-00748-2The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysisZhihong Zhu0Liangyou Guo1Maoxian Yang2Junya Cheng3Department of Nursing, The First Hospital of Jiaxing & Affiliated Hospital of Jiaxing UniversityGraduate School, Zhejiang Chinese Medical UniversityDepartment of Intensive Care Unit, The First Hospital of Jiaxing & Affiliated Hospital of Jiaxing UniversityDepartment of Nursing, The First Hospital of Jiaxing & Affiliated Hospital of Jiaxing UniversityAbstract Background Achieving and maintaining viral suppression and optimal adherence to antiretroviral therapy are crucial for improving health outcomes in general population of people living with HIV. This study aimed to evaluate the effects of monetary incentives on these key treatment goals. Methods We conducted a systematic review and meta-analysis, searching the Cochrane Library, Medline, EMBASE, CINAHL, Web of Science, and Scopus databases from inception to March 2025. We included randomized controlled trials comparing monetary incentives with routine care in people living with HIV. The primary outcomes were viral suppression and adherence to antiretroviral therapy. Random-effects meta-analyses were used to calculate pooled odds ratios with 95% confidence intervals. This study was registered with PROSPERO (registration number CRD42024524374). Results Thirteen randomized controlled trials were included. Compared with routine care, monetary incentives significantly improved viral suppression (OR = 1.39,95%CI: 1.11, 1.74); p = 0.004; I²=42%), adherence to antiretroviral therapy (OR = 1.62,95%CI: 1.13,2.31; p = 0.008; I²=30%) and retention in care (OR = 1.27, 95% CI: 1.02–1.57; p = 0.03; I²=9%). The difference in CD4 + T-cell counts between groups did not reach statistical significance (SMD = -38.90, 95% CI: -77.35 to -0.45; p = 0.05), with low heterogeneity (I² = 28%). Conclusion Monetary incentives effectively improve viral suppression and adherence to antiretroviral therapy among people living with HIV. Integrating monetary incentives into HIV care models could be a promising strategy to optimize treatment outcomes. Further research is needed to assess the long-term sustainability and cost-effectiveness of such interventions.https://doi.org/10.1186/s12981-025-00748-2Monetary incentivesViral suppressionTreatment adherencePeople living with HIVMeta-analysis |
| spellingShingle | Zhihong Zhu Liangyou Guo Maoxian Yang Junya Cheng The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysis AIDS Research and Therapy Monetary incentives Viral suppression Treatment adherence People living with HIV Meta-analysis |
| title | The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysis |
| title_full | The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysis |
| title_fullStr | The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysis |
| title_full_unstemmed | The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysis |
| title_short | The effectiveness of monetary incentives in improving viral suppression, treatment adherence, and retention in care among the general population of people living with HIV: a systematic review and meta-analysis |
| title_sort | effectiveness of monetary incentives in improving viral suppression treatment adherence and retention in care among the general population of people living with hiv a systematic review and meta analysis |
| topic | Monetary incentives Viral suppression Treatment adherence People living with HIV Meta-analysis |
| url | https://doi.org/10.1186/s12981-025-00748-2 |
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