Effect of CBD incentive on linkage to additional care and uptake of self-testing
Conditional incentive | No incentive | Prevalence ratio | Prevalence difference | P value | k | N | |||
n/N | % | n/N | % | 95% CI | 95% CI | ||||
Primary outcome | |||||||||
Linkage to any services | 1062/3698 | 28.7 | 1075/3448 | 31.2 | 0.94 (0.86 to 1.03) | −0.017 (−0.042 to 0.007) | 0.17 | 0.05 | 7146 |
Secondary outcomes and post-hoc analyses | |||||||||
Uptake of self-testing | 1770/3698 | 47.9 | 1823/3448 | 52.9 | 0.91 (0.80 to 1.02) | −0.048 (−0.109 to 0.012) | 0.116 | 0.05 | 7146 |
Uptake of PSI outreach services | 94/1770 | 5.3 | 106/1823 | 5.8 | 0.92 (0.68 to 1.24) | −0.005 (−0.021 to 0.012) | 0.57 | 0.38 | 3593 |
Uptake of VMMC among men | 19/854 | 2.2 | 12/853 | 1.4 | 1.76 (0.77 to 4.03) | 0.01 (−0.005 to 0.024) | 0.186 | 0.74 | 1707 |
Uptake of confirmatory testing for reactive self-tests | 88/157 | 56.1 | 72/132 | 54.5 | 1.02 (0.82 to 1.28) | 0.011 (−0.100 to 0.122) | 0.845 | * | 289 |
Post-hoc analysis: uptake of confirmatory testing for reactive self-tests if not already on ART and or in HIV care | 25/33 | 75.8 | 20/40 | 50 | 1.59 (1.05 to 2.39) | 0.256 (0.042 to 0.470) | 0.019 | – | 73 |
Initiation of ART among all participants who reported a reactive self-test result | 15/157 | 9.6 | 12/132 | 9.1 | 1.03 (0.50 to 2.15) | 0.003 (−0.064 to 0.070) | 0.932 | 1.36 | 289 |
Post-hoc analysis: uptake of ART among HIV-positive participants not previously in HIV care (ie, excluding those participants already on ART) | 15/33 | 45.5 | 12/40 | 30 | 1.52 (0.48 to 4.81) | 0.151 (−0.168 to 0.470) | 0.354 | – | 73 |
Adjusted models include adjustment for educational attainment (none/primary, some secondary, O-levels complete, A-levels and above), household food insecurity (moderate/severe food insecurity, no/mild food insecurity) and high SSQ (Shona Symptom Questionnaire) score (nine or higher).
ART, antiretroviral therapy; CBD, community-based distributors; PSI, Population Services International; VMMC, voluntary medical male circumcision .