Online Program

Testing with Benefits: Results from a Contingency Management Program to Reduce Recurrent STIs in High-Risk MSM

Tuesday, November 3, 2015 : 12:30 p.m. - 12:50 p.m.

Mark McGrath, MPH, Public Health Division, AIDS Healthcare Foundation, Los Angeles, CA
Laura Anderson, MPH, Department of Epidemiology, University of California, Los Angeles Jonathan and Karin Fielding School of Public Health, Los Angeles, CA
Matthew Beymer, MPH, Sexual Health Program, Los Angeles LGBT Center, Los Angeles, CA
Adam Cohen, MPH, Public Health Division, AIDS Healthcare Foundation, Los Angeles, CA
Lauren Natoli, B.A., Public Health Division, AIDS Healthcare Foundation, Los Angeles, CA
Marjan Javanbakht, PhD, Department of Epidemiology, Fielding School of Public Health, Los Angeles, CA
Jeffrey Klausner, MD, MPH, Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, CA
Background: Sexually transmitted infections (STIs) contribute to HIV transmission. The increased burden of STIs among men who have sex with men (MSM) partially explains elevated HIV incidence. Research suggests monetary incentives can motivate behavior change. We describe preliminary findings from a pilot program utilizing financial incentives to increase repeat STI/HIV testing among MSM in Los Angeles, CA.

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

Learning Objectives:
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

Presenting author's disclosure statement:

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.