We're very pleased to report that we've been given the opportunity by the U.S. National Institutes of Health to continue our work on HIV treatment adherence in Tanzania in collaboration with Health for a Prosperous Nation, the Ministry of Health, Community Development, Gender, Elderly, and Children, and Management and Development for Health. Over the next 5 years, we'll optimize the size and delivery of a short-term cash transfer and test its effectiveness for reducing HIV viral load in a cluster randomized trial. We'll use an innovative biometric delivery model linked to SMS and mobile banking developed by the communications firm Rasello. Read more about the new project here.
This week our team traveled to Paris for the 9th International AIDS Society Conference on HIV Science where we presented our latest research findings. Doctoral student Carolyn Fahey presented her work on the effects of short-term cash and food assistance on food insecurity and labor force participation among HIV-infected adults in Tanzania (watch her presentation here and see her abstract #TUAD0204 in the abstract book). Recent MPH graduate Jillian Kadota presented an analysis that found that cash transfers do not increase the use of temptation goods like alcohol, a reassuring finding consistent with prior literature on cash transfers. She also presented an analysis which found that cash and food transfers work the best among those who were recently initiated on antiretroviral therapy and among the poorest patients, which may be related to the cost of transportation to the clinic. These data can be used to better design future cash transfer programs for people living with HIV infection in Tanzania and elsewhere. Lastly, we presented the results of our study that used human-centered design to develop an intervention using social norms and priming to improve adherence to antiretroviral therapy and retention in care among adults with HIV in Tanzania (watch the presentation here and read about the full study in PLoS One). We also published a two-part series on this study in the Stanford Social Innovation Review (see Part I and Part II). A very successful week for our research team and we are enthusiastic about incorporating the new ideas and perspectives we learned in Paris into our future work.
Congratulations to the UC Berkeley School of Public Health Class of 2017! Our team's graduates will enter the workforce as newly minted epidemiologists and many will share their research this summer at national and international scientific meetings. Jillian Kadota is one such student. As part of her MPH summer internship, she spearheaded a multidisciplinary study in Tanzania to understand the effects of heavy load carrying on women's health. Jillian collected qualitative and quantitative information from women about how much water, wood, or other substances they carry every day and their self-reported health. She also weighed their loads, took pictures and videos to characterize their posture and gait, and asked a subset of women to wear personal devices to capture biometric data. With this information she plans to assess the potential health effects of heavy load carrying. This is an especially salient topic in East Africa where mechanized transportation is scarce and women and girls bear most of the carrying burden. Furthermore, musculoskeletal injuries - often related to carrying heavy loads - comprise the largest burden of disease globally; both the 1990 and 2013 Global Burden of Disease studies listed low back pain as the number one contributor to years lost to disability (YLD). You can read more about her work here and in an upcoming publication.
Two of our former UC Berkeley students recently published new findings that describe how people in Tanzania use the incentives they receive in exchange for engaging in beneficial health behaviors. In a qualitative study led by Dr. Nancy Czaicki and published in AIDS Care, our team found that people living with HIV who received monthly cash or food assistance when they visited the HIV clinic reported myriad beneficial effects on household welfare. Participants reported that incentives were predominantly used for food, school fees, and investing in businesses. There were no reports of harmful events associated with the incentives. In a second qualitative study published in Social Science & Medicine, Dr. Jan Cooper examined how female sex workers in Dar es Salaam changed their behavior in order to receive a cash transfer conditional on staying free of sexually transmitted infections. Although many of the women had limited ability to insist on condom use with sexual partners, they reported substantial power over their work logistics, such as reducing the number of workdays and clients, that they leveraged to meet the conditions of the incentive program. This is an important new finding that adds to what we know about how incentives help women achieve health goals. Together, these studies add to the growing evidence base about the benefits of cash and other kinds of incentives for improving health and welfare in sub-Saharan Africa.
Our team is thrilled to announce the results of our randomized trial comparing the effectiveness of conditional cash and food transfers to improve adherence to antiretroviral therapy and retention in HIV care among adults in Tanzania. The study found that both food assistance and cash transfers increased adherence to treatment and reduced loss to follow-up, although cash transfers were more effective than food assistance after the incentive period was over. We also found that cash transfers cost less than food transfers, are easier to implement, and are often preferred by patients. The presentation at AIDS 2016 (Durban, South Africa) can be viewed here and the results are available starting January 2017 in the journal AIDS. The study was a collaboration between UC Berkeley, the Shinyanga Regional Medical Office, and the Ministry of Health, Community Development, Gender, Elderly, and Children. It was funded by the U.S. National Institutes of Health.
This month the world lost a talented young scholar who was a joy to have on our research team. Dr. Nancy Czaicki was a doctoral student in our research group from 2012 to 2016 and was most recently working at the Centre for Infectious Disease Research in Zambia. She played an integral role in the launch of our study to evaluate the effectiveness of food and cash transfers, and she was leading her own research to understand how incentives change human behavior. Nancy deeply cared about ending the HIV epidemic and she was committed to helping people with HIV to live longer and healthier lives. We will miss our lively scientific debates, our fearless traveling companion, and the world will miss out on the contributions of a very talented scientist. Read more about Dr. Czaicki and her impact on everyone who met her here.
We're recruiting 18-26 year old gay/bi/queer men in Oakland and Hollywood to participate in a project using gamification to improve sexual health. The rePLAY Project is a collaboration between AIDS Healthcare Foundation, UC Berkeley, and UCLA. Our goal is to strengthen the relationship between millennial gay/bi/queer men in California and existing sexual health programs. In order to do this, we focus on creating fun and engaging experiences using technology and games.
Want to join in on the fun? Click the link above to sign up!
We are proud to announce the launch of a new project to determine whether gamification, the use of game elements in non-game settings, can improve the sexual health of gay and bisexual men in California. The project is funded by the U.S. National Institutes of Health and is a collaboration between UC Berkeley, AIDS Healthcare Foundation, and UCLA. Our goal is to to encourage young high-risk gay and bisexual men to be regularly screened for HIV and other sexually transmitted infections (STIs) and to adopt safer sexual behaviors. The results from the study will provide guidance about whether interventions using gamification can reduce high-risk behavior and decrease the incidence of HIV and STIs among young MSM. Read more about the project in the UC Berkeley newsroom.