A Study on the Effectiveness of Behaviorally Informed Interventions on Increasing Retention in Care Among HIV-Positive Adolescents in Haiti

Abstract

One of the most non-normative ways that people behave is seen in the disconnect between individuals’ intentions to do something and failure to act on these intentions and carry out the behaviors. This is clearly seen in the case of individuals failing to properly adhere to their medication or stay in medical care. This study looks at the effectiveness of a behaviorally informed intervention at increasing patient retention in care among 53 HIV-positive adolescents in the GHESKIO clinic in Port-au-Prince, Haiti. The behaviorally informed intervention draws upon research on decision making in the context of poverty, group interventions, and incentives as a lever of behavior change. Together, insights from these bodies of literature were combined to form the intervention of a Teen Club. Patients were assigned to a Teen Club that met on a monthly basis. Group meetings consisted of an educational component, a health checkup, and a social element. Teen Clubs were an incentive program: if 80% of the group members showed up, all participants received mobile airtime minutes as a reward. If the group had three consecutive months of at least 80% retention, participants received a celebratory activity of their choice. It was hypothesized that patients in the Teen Clubs were more likely to be retained in care than patients who received individual care. This study found that Teen Club members were almost three times more likely to be retained in care than patients who received individual care. This research concludes that a behaviorally informed intervention that is specifically tailored to account for these patients’ unique financial situation, age, and HIV-positive status, successfully increased the likelihood that they would be retained in care. These results suggest that behaviorally informed interventions are an effective way to motivate behavior change, and should be considered for similar situations in the future.