ABSTRACT This study evaluated the safety and preliminary efficacy of a group-based conditional economic incentives (CEI) program for ART adherence improvement among a sample of adolescents living in Ghana. A total of 35 adolescents (mean age: 14.7 years) on ART, though still with detectable viral load, were recruited from an HIV clinic and divided into 5 balanced groups to participate in peer-led group-based CEI activities during routine clinic visits. Four assessments were conducted across four visits at baseline and 3-, 6-, and 9-month follow-up, respectively. Main outcomes were ART adherence and viral load. Linear mixed models and thematic analysis were used for data analyses. The majority (91.4%) of the participants attended all four intervention activities. Participants reported missing an average of 1.06, 0.50, 0.91, 0.55 doses of ART in the past 7 days at baseline, 3-, 6-, and 9-month assessments, respectively. Most viral loads were ≥5,000 copies/ml at both baseline (68.6%) and 6-month assessments (54.3%). The incentive was divided between individual compensation for attending clinic and completing the assessment ($5 each, $20 in total) and a group-based compensation valued at $40 that was distributed during the 9-month assessment according to average group attendance (A ≥ 90%, B ≥ 75%, C ≥ 60%, D < 60%) and group-average viral load (A = undetectable, B = 50–499, C = 500–4999, D ≥ 5,000). The mean earnings for the participants was $46.70 (77.8% of possible earning). Qualitative data suggested that the CEI helped ART adherence through gaining personal and group benefits. Participants reported no teasing, bullying, or other undesirable behaviors from group members. They liked getting money for attending clinics/group meetings and obtaining undetectable viral load. We concluded that a group-based CEI was safe and had the potential to improve ART adherence and reduce viral load among Ghanaian adolescents.

中文翻译：

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基于团体的经济激励措施，以提高艾滋病毒感染青年对抗逆转录病毒疗法的依从性：一项试验性试验的安全性和初步疗效

摘要这项研究评估了一个基于群体的有条件经济诱因（CEI）计划在居住在加纳的青少年中改善ART依从性的安全性和初步疗效。尽管仍具有可检测的病毒载量，但仍从艾滋病诊所招募了35名接受抗逆转录病毒治疗的青少年（平均年龄：14.7岁），并分成5个平衡组参加常规门诊期间由同行领导的基于小组的CEI活动。在基线和3个月，6个月和9个月的随访中，分别对4次访问进行了4次评估。主要结果是坚持抗逆转录病毒疗法和病毒载量。线性混合模型和主题分析用于数据分析。大部分（91.4％）的参与者参加了所有四个干预活动。参与者报告平均缺失1.06、0.50、0.91、0。在过去7天内，分别在基线，3、6和9个月评估中接受了55剂抗病毒药物。在基线（68.6％）和6个月评估（54.3％）时，大多数病毒载量均≥5,000拷贝/ ml。激励措施分为个人就诊和完成评估的报酬（每人5美元，总计20美元）和基于团体的价值40美元的薪酬，该薪酬在9个月的评估期间根据平均团体出勤率分配（A≥90％ ，B≥75％，C≥60％，D <60％）和组平均病毒载量（A =不可检测，B = 50–499，C = 500–4999，D≥5,000）。参与者的平均收入为46.70美元（占可能收入的77.8％）。定性数据表明，CEI通过获得个人和团体利益帮助了ART的遵守。参与者报告没有戏弄，欺凌，或小组成员的其他不良行为。他们喜欢赚钱参加诊所/小组会议并获得无法检测的病毒载量。我们得出的结论是，基于小组的CEI是安全的，并且有可能改善加纳青少年的抗逆转录病毒依从性并减少病毒载量。