{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T12:52:15Z","timestamp":1788871935412,"version":"build-2803163510"},"reference-count":38,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,9,15]],"date-time":"2022-09-15T00:00:00Z","timestamp":1663200000000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","award":["R01 NR018801"],"award-info":[{"award-number":["R01 NR018801"]}],"id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR002346"],"award-info":[{"award-number":["KL2 TR002346"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Int AIDS Soc."],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>To develop a patient\u2010centred financial incentive delivery strategy to improve antiretroviral treatment adherence in adolescents and young adults (AYA) living with HIV in Kisumu, Kenya, we conducted a mixed methods study exploring preferences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A discrete choice experiment (DCE) and focus group discussion (FGD) were conducted simultaneously to identify preferences for five incentive delivery strategy features: value, eligibility, recipient, format and disbursement frequency. We used consecutive sampling to recruit AYA (14\u201324\u00a0years) living with HIV attending three health facilities in Kisumu, Kenya. We calculated mean preferences, willingness to trade, latent class membership and predictors of latent class membership. The FGD explored preferred incentive features, and, after deductive and inductive coding, qualitative findings were triangulated with DCE results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and seven AYA living with HIV (46% 14\u201317\u00a0years, 54% 18\u201324\u00a0years; 33% male sex, 89% viral load &lt;50\u00a0copies\/ml) were recruited to the study (28 October\u201316 November 2020). Two distinct preference phenotypes emerged from the DCE analysis (<jats:italic>N<\/jats:italic> = 199), 44.8% of the population fell into an \u201cimmediate reward\u201d group, who wanted higher value cash or mobile money distributed at each clinic visit, and 55.2% fell into a \u201cmoderate spender\u201d group, who were willing to accept lower value incentives in the form of cash or shopping vouchers, and accrued payments. The immediate reward group were willing to trade up to 200 Kenyan Shillings (KSH)\u2014approximately 2 US dollars (USD)\u2014of their 500 KSH (\u223c5 USD) incentive to get monthly as opposed to accrued yearly payments. The strongest predictor of latent class membership was age (RR 1.45; 95% CI: 1.08\u20131.95; <jats:italic>p<\/jats:italic> = 0.006). Qualitative data highlighted the unique needs of those attending boarding school and confirmed an overwhelming preference for cash incentives which appeared to provide the greatest versatility for use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Providing small financial incentives as cash was well\u2010aligned with AYA preferences in this setting. AYA should additionally be offered a choice of other incentive delivery features (such as mobile money, recipient and disbursement frequency) to optimally align with the specific needs of their age group and life stage.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jia2.25979","type":"journal-article","created":{"date-parts":[[2022,9,16]],"date-time":"2022-09-16T03:28:47Z","timestamp":1663298927000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Adolescent and young adult preferences for financial incentives to support adherence to antiretroviral therapy in Kenya: a mixed methods study"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4049-9868","authenticated-orcid":false,"given":"Ingrid","family":"Eshun\u2010Wilson","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliud","family":"Akama","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fridah","family":"Adhiambo","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5117-5084","authenticated-orcid":false,"given":"Zachary","family":"Kwena","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6537-6792","authenticated-orcid":false,"given":"Bertha","family":"Oketch","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Obatsa","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9019-6032","authenticated-orcid":false,"given":"Sarah","family":"Iguna","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayne L.","family":"Kulzer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology, and Reproductive Services University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Nyanga","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Everlyne","family":"Nyandieka","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ally","family":"Scheve","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0825-1424","authenticated-orcid":false,"given":"Elvin H.","family":"Geng","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine Washington University in St. Louis  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Bukusi","sequence":"additional","affiliation":[{"name":"Research Care Training Program, Centre for Microbiology Research Kenya Medical Research Institute  Kisumu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Abuogi","sequence":"additional","affiliation":[{"name":"Division of Pediatrics University of Colorado  Boulder Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-013-0415-2"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1257\/000282803321947001"},{"key":"e_1_2_11_4_1","volume-title":"Nudge: improving decisions about health, wealth, and happiness","author":"Thaler RH","year":"2008"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.298.20.2415"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.7448\/IAS.20.4.21520"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/COH.0000000000000459"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cobeha.2015.09.004"},{"key":"e_1_2_11_9_1","unstructured":"Elizabeth Glaser Foundation (EGPAF).Incentives handbook for adolescents and health care providers.Kenya;2017. Available from:https:\/\/www.pedaids.org\/resource\/incentives-handbook-for-adolescents-and-health-care-providers-kenya\/. Last accessed: August 12 2022."},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30176-5"},{"issue":"1","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1186\/s12913-017-2253-9","article-title":"Continuous quality improvement interventions to improve long\u2010term outcomes of antiretroviral therapy in women who initiated therapy during pregnancy or breastfeeding in the Democratic Republic of Congo: design of an open\u2010label, parallel, group randomized trial","volume":"17","author":"Yotebieng M","year":"2017","journal-title":"BMC Health Serv Res"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(16)30253-4"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/17450128.2019.1709678"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002215"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2031-8"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000002201"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11904-020-00520-3"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100653"},{"key":"e_1_2_11_19_1","unstructured":"AkamaE OdenyT BukusiE GengEH AbougiL. ADAPT for Adolescents Adolescents (A4A)clinicaltrials.gov:clinicaltrials.gov;2021[cited 2021]. Available from:https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04432571. Last accessed: August 12 2022."},{"key":"e_1_2_11_20_1","unstructured":"Kenya HIV estimates.2018. Available from:http:\/\/nacc.or.ke\/wp\u2010content\/uploads\/2018\/12\/HIV\u2010estimates\u2010report\u2010Kenya\u201020182.pdf. Last accessed: August 12 2022."},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-010-0314-z"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3109\/14659891.2015.1118563"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13561-019-0247-5"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2010.11.013"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2012.08.2223"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/01441640902827623"},{"key":"e_1_2_11_27_1","unstructured":"Sawtooth Software. The CBC system for choice\u2010based conjoint analysis.Technical Paper Series.2007."},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/1536867X0700700306"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2278"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1257\/jel.40.2.351"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084317"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10461-021-03443-1"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2020.113333"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2015-103359"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1002\/jia2.25636"},{"issue":"11","key":"e_1_2_11_36_1","first-page":"Cd006417","article-title":"School\u2010based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents","volume":"11","author":"Mason\u2010Jones AJ","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003509"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-698X-14-10"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003020"}],"container-title":["Journal of the International AIDS Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25979","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jia2.25979","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jia2.25979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T05:50:33Z","timestamp":1692683433000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jia2.25979"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9]]},"references-count":38,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2022,9]]}},"alternative-id":["10.1002\/jia2.25979"],"URL":"https:\/\/doi.org\/10.1002\/jia2.25979","archive":["Portico"],"relation":{},"ISSN":["1758-2652","1758-2652"],"issn-type":[{"value":"1758-2652","type":"print"},{"value":"1758-2652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9]]},"assertion":[{"value":"2022-01-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-15","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e25979"}}