The Empower Nudge lottery to increase dual protection use: a proof-of-concept randomised pilot trial in South Africa

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dc.contributor.authorGalárraga, Omar
dc.contributor.authorHarries, Jane
dc.contributor.authorMaughan-Brown, Brendan
dc.contributor.authorCooper, Diane
dc.contributor.authorShort, Susan E.
dc.contributor.authorLurie, Mark N.
dc.contributor.authorHarrison, Abigail
dc.date.accessioned2018-11-19T07:42:34Z
dc.date.available2018-11-19T07:42:34Z
dc.date.issued2018
dc.description.abstractThe objective of this study is to measure the preliminary efficacy of a pilot intervention, grounded in behavioural economics, increasing adherence of dual protection (simultaneous use of effective modern contraception and a barrier method, such as a condom) to protect against HIV, other sexually transmitted infections, and unintended pregnancy. Between 2015 and 2016, 100 women aged 18–40 years, seeking post-abortion care in Cape Town, South Africa were recruited to Empower Nudge, a randomised controlled trial to test a lottery incentive intervention designed to increase dual protection. At baseline, the mean age of participants was 27 years; 82% of them were from South Africa; 58% self-identified as Black African; average education completed was 11.7 years. At three months, assignment to the lottery intervention was associated with higher odds of returning for study visits (OR: 6.0; 95%CI: 2.45 to 14.7, p < 0.01), higher condom use (OR: 4.5; 95%CI: 1.43 to 14.1; p < 0.05), and higher use of dual protection (OR: 3.16; 95%CI: 1.01 to 9.9; p < 0.05). Only 60% of the study population returned after three months and only 38% returned after six months. Women who receive post-abortion care represent a neglected population with an urgent need for HIV and pregnancy prevention. Dual protection is a critically important strategy for this population. Lottery-based behavioural economics strategies may offer possible ways to increase dual protection use in this population. Further research with larger samples, longer exposure time, and more sites is needed to establish fully powered efficacy of lottery incentives for dual protection; using objective verification for monitoring.en_US
dc.identifier.citationGalárraga, O. et al. (2018). The Empower-Nudge lottery to increase dual protection use: a proof-of-concept randomised pilot trial in South Africa. Reproductive Health Matters, 26(52): 1510701.en_US
dc.identifier.issn0968-8080
dc.identifier.urihttp://dx.doi.org/10.1080/09688080.2018.1510701
dc.identifier.urihttp://hdl.handle.net/10566/4206
dc.language.isoenen_US
dc.privacy.showsubmitterFALSE
dc.publisherInforma UK Limited, trading as Taylor & Francis Groupen_US
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http:// creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
dc.status.ispeerreviewedTRUE
dc.subjectBehavioural economicsen_US
dc.subjectConditional economic incentivesen_US
dc.subjectDual protectionen_US
dc.subjectHIV preventionen_US
dc.subjectLong-acting reversible contraceptivesen_US
dc.subjectPost-abortion careen_US
dc.subjectSouth Africaen_US
dc.titleThe Empower Nudge lottery to increase dual protection use: a proof-of-concept randomised pilot trial in South Africaen_US
dc.typeArticleen_US

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