Testing with Benefits: Results from a Contingency Management Program to Reduce Recurrent STIs in High-Risk MSM
Methods: Starting October 2013, MSM seeking sexual health care at AIDS Healthcare Foundation were enrolled if they were 18 years or older and diagnosed with a rectal STI within the past two years. Participants received STI/HIV testing at baseline and re-testing every three months for one year. Participants received a $50 gift card for each testing visit and another $50 gift card if STI-free.
Results: At baseline, 50% (104/208) of men tested positive for any STI: 22% (45/203) tested positive for gonorrhea, 33% (66/203) for chlamydia, and 8% (17/202) for early syphilis. Thirteen percent (27/208) were HIV-positive and 2% (3/181) were newly diagnosed with HIV. At one year program retention remained high (78%) and STI prevalence decreased significantly from baseline (50% to 16 %; p<0.01). Chlamydia decreased from 33% at baseline to 8% at one year (p<0.01) and gonorrhea fell significantly as well (22% vs. 8%, at baseline and one year, respectively; p =0.04). Six recent HIV infections were identified.
Conclusion: While participant retention was very good and the overall prevalence of STIs decreased, HIV incidence remained high. Future analyses can determine the efficacy of monetary incentive programs to reduce STI/HIV incidence among MSM.
Learning Areas:Public health or related research
Identify populations at greatest risk for HIV in Los Angeles, CA Describe the research behind monetary incentive programs to reduce HIV infections Compare the cost-benefit of monetary incentive programs to other existing HIV prevention tools
Keyword(s): STDs/STI, HIV Risk Behavior
Qualified on the content I am responsible for because: Mr. Mark McGrath is a Policy and Research Analyst at the AIDS Healthcare Foundation (AHF). Mark has 10 years of experience working with high-risk communities, including commercial sex workers, MSM, and incarcerated veterans. He has been co-investigator on two verification/validation studies for HIV and syphilis assays. He has also been co-investigator on behavioral health studies targeting sex workers and primary investigator on a behavioral study targeting high-risk MSM.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.