Background: Black people living with HIV face economic hardship and structural barriers affecting health outcomes. While conditional cash transfers may improve HIV care engagement, unconditional assistance remains unexplored in the U.S. This pilot examines the impact of providing basic income guarantee (BIG) to this population in Chicago. This study evaluates effects of a 12-month Basic Income Guarantee on viral suppression rates among participants.

Methods: Using the ADAPT-ITT implementation science framework, we have adapted the Chicago Resilient Communities Pilot to provide 10 BPLWH participants with BIG at $500 per month for 12 months. Acceptability and feasibility are being assessed through validated implementation measures (FIM/AIM), and surveys at baseline, 3, 6, 12, and 18 months to evaluate economic stability, healthcare engagement, and psychosocial well-being with in-depth-interviews conducted at the same intervals.

Results Early findings suggest BIG positively impacts economic stability and HIV care. At baseline, 70% of participants had stable housing, 80% were virally suppressed, and 56% experienced food insecurity. Initial 3-month data from one participant showed substantial improvements in financial well-being, elimination of food insecurity, and maintenance of viral suppression. Implementation assessments demonstrate high acceptability (3.8/5) and feasibility (3.3/5), suggesting BIG offers a viable intervention for addressing health disparities among BPLWH.

Conclusions: Preliminary data indicate that BIG may enhance economic security and health outcomes for BPLWH. If sustained, BIG could serve as a scalable intervention to reduce HIV disparities and improve well-being for PLWH and other populations made vulnerable through poor social determinants of health facing economic insecurity