Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 10;21(1):477.
doi: 10.1186/s12889-021-10499-0.

Role of temporal discounting in a conditional cash transfer (CCT) intervention to improve engagement in the prevention of mother-to-child transmission (PMTCT) cascade

Jessica Londeree Saleska  1   2 , Abigail Norris Turner  3 , Maria F Gallo  4 , Abigail Shoben  4 , Bienvenu Kawende  5 , Noro Lantoniaina Rosa Ravelomanana  4   5 , Harsha Thirumurthy  6   7 , Marcel Yotebieng  8
Affiliations

Role of temporal discounting in a conditional cash transfer (CCT) intervention to improve engagement in the prevention of mother-to-child transmission (PMTCT) cascade

Jessica Londeree Saleska et al. BMC Public Health. .

Abstract

Background: Temporal discounting, the tendency of individuals to discount future costs and benefits relative to the present, is often associated with greater engagement in risky behaviors. Incentives such as conditional cash transfers (CCTs) have the potential to counter the effects of high discount rates on health behaviors.

Methods: With data from a randomized trial of a CCT intervention among 434 HIV-positive pregnant women in the Democratic Republic of Congo, we used binomial models to assess interactions between discount rates (measured using a delay-discounting task) and the intervention. The analysis focused on two outcomes: 1) retention in HIV care, and 2) uptake of prevention of mother-to-child transmission (PMTCT) services.

Results: The effect of high discount rates on retention was small, and we did not observe evidence of interaction between high discount rates and CCT on retention. However, our findings suggest that CCT may mitigate the negative effect of high discount rates on uptake of PMTCT services (interaction contrast (IC): 0.18, 95% CI: - 0.09, 0.44).

Conclusions: Our findings provide evidence to support the continued use of small, frequent incentives, to motivate improved uptake of PMTCT services, especially among women exhibiting high rates of temporal discounting.

Trial registration: Clinicaltrials.gov number NCT01838005 , April 23, 2013.

Keywords: HIV; Intertemporal preferences; PMTCT Cascade; Prevention of mother-to-child transmission of HIV (PMTCT); Temporal discounting.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Fowler MG, et al. Benefits and risks of antiretroviral therapy for perinatal HIV prevention. N Engl J Med. 2016;375(18):1726–1737. doi: 10.1056/NEJMoa1511691. - DOI - PMC - PubMed
    1. Dabis F, Ekpini ER. HIV-1/AIDS and maternal and child health in Africa. Lancet (London, England) 2002;359(9323):2097–2104. doi: 10.1016/S0140-6736(02)08909-2. - DOI - PubMed
    1. UNAIDS, “Global HIV & AIDS statistics — 2019 fact sheet,” 2019. https://www.unaids.org/en/resources/fact-sheet (Accessed 23 Oct 2019).
    1. S. M. Stricker et al., “Retention in care and adherence to ART are critical elements of HIV care interventions.,” AIDS Behav., vol. 18 Suppl 5, no. S5, pp. S465–S475, 2014, doi: 10.1007/s10461-013-0598-6. - PubMed
    1. Barker PM, Mphatswe W, Rollins N. Antiretroviral drugs in the cupboard are not enough: the impact of health systems’ performance on mother-to-child transmission of HIV. J Acquir Immune Defic Syndr. 2010;00(0):1–4. doi: 10.1097/QAI.0b013e3181fdbf20. - DOI - PubMed

Publication types

Associated data