Combining financial incentives and peer support to improve adolescent outcomes in HIV

Partner: University of Kigali | Location: Rwanda


HIV is evolving into an adolescent epidemic.

Globally, 2.1 million adolescents and 3.3 million children are living with HIV/AIDS. Between 2005 and 2012 the total number of HIV-related deaths fell by 30%. However, amongst adolescents HIV related deaths increased by 50%.

Poor adherence to anti-retroviral therapy is driving poor outcomes for adolescents.

The world health organization recently issued an urgent call for novel interventions to improve adherence amongst adolescents. In Rwanda, 29% of adolescents living with HIV have non-suppressed viral load because of poor treatment adherence.

D2 Youth Center.png


To address this challenge we have been working with the University of Kigali to develop a program with three components to improve adherence and outcomes for these adolescents.

  1. Incentives: Using the power of financial savings and inclusion to motivate healthy choices.

  2. Peer Support: Teens helping teens through peer mentoring to stick to their medications and stay well.

  3. Life-skills: Provide young people with the skills to invest their savings and plan their future livelihoods.


Next Steps

We found that this intervention was acceptable among youth and caregivers. Financial incentives, combined with a supportive environment and adequate skills-training, show promise in motivating health behavior change in adolescents living with HIV. This study indicated a need for mixed-methods in designing youth-targeted financial services and evaluating their efficacy over time using large multi-site RCTs.

richelle reed