Incentivizing adherence to pre-exposure prophylaxis for HIV prevention: a randomized pilot trial among male sex workers in Mexico

Omar Galárraga (), Marta Wilson-Barthes (), Carlos Chivardi (), Nathalie Gras-Allain (), Fernando Alarid-Escudero (), Monica Gandhi (), Kenneth H. Mayer () and Don Operario ()
Additional contact information
Omar Galárraga: Brown University School of Public Health
Marta Wilson-Barthes: Brown University School of Public Health
Carlos Chivardi: National Institute of Public Health (INSP)
Nathalie Gras-Allain: Clínica Especializada Condesa
Fernando Alarid-Escudero: Center for Economics Teaching and Research (CIDE)
Monica Gandhi: University of California
Kenneth H. Mayer: The Fenway Institute
Don Operario: Emory University

The European Journal of Health Economics, 2025, vol. 26, issue 2, No 10, 299-311

Abstract: Abstract Low adherence to preventative medications against life-long health conditions is a major contributor to global morbidity and mortality. We implemented a pilot randomized controlled trial in Mexico to measure the extent to which conditional economic incentives help male sex workers increase their adherence to pre-exposure prophylaxis (PrEP) for HIV prevention. We followed n = 110 male sex workers over 6 months. At each quarterly visit (at months 0, 3, and 6), all workers received a $10 transport reimbursement, a free 3-month PrEP supply, and completed socio-behavioral surveys. The primary outcome was an objective biomarker of medication adherence based on tenofovir (TFV) drug concentration levels in hair collected at each visit. Individuals randomized to the intervention received incentives based on a grading system as a function of PrEP adherence: those with high (> 0.043 ng/mg TFV concentration), medium (0.011 to 0.042 ng/mg), or low (

Keywords: Conditional economic incentives; Adherence; HIV prevention; Pre-exposure prophylaxis (PrEP); Male sex workers; I120; I150; O150 (search for similar items in EconPapers)
Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s10198-024-01705-y Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:eujhec:v:26:y:2025:i:2:d:10.1007_s10198-024-01705-y

Ordering information: This journal article can be ordered from
http://www.springer. ... cs/journal/10198/PS2

DOI: 10.1007/s10198-024-01705-y

Access Statistics for this article

The European Journal of Health Economics is currently edited by J.-M.G.v.d. Schulenburg

More articles in The European Journal of Health Economics from Springer, Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ) Contact information at EDIRC.
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().