Synovectomy of the knee in rheumatoid arthritis. I. Short-term observations.

Abstract

<h3>Background</h3> Understanding the mechanisms underlying health behaviors is crucial to optimize interventions to improve HIV-related outcomes. Temporal discounting (TD), the tendency to discount the value of future rewards relative to rewards received closer to the present, may lead to risky health behaviors. Conditional cash transfer (CCT) interventions were developed in part to mitigate these effects. Despite this, few studies assess the direct role of TD on the effect of CCT interventions on HIV treatment and prevention. <h3>Methods</h3> Using data from a randomized controlled trial among 433 HIV-infected pregnant women in the Democratic Republic of Congo, we assessed three outcomes:1) retention to HIV care, 2) uptake of services for the prevention of mother-to-child transmission (PMTCT), and 3) viral suppression at 6 weeks postpartum. We used a delay discounting task to measure TD at baseline. We hypothesized that if CCT works by mitigating the harmful effects of TD, we would observe a positive interactive effect on the additive scale between high TD and CCT. We specified linear binomial regression models to calculate the individual and joint effects of CCT and TD, and we calculated the interaction contrast (IC) to illustrate possible interaction between these effects. <h3>Results</h3> The effect of CCT on uptake of PMTCT services was greater among women exhibiting high TD. The IC suggested a positive interactive effect between TD and the CCT intervention on uptake of PMTCT services (IC: 0.17; 95% CI: -0.15, 0.48). We observed no evidence of additive interaction between TD and the CCT intervention on retention or viral suppression. <h3>Conclusion</h3> This CCT intervention may help mitigate the harmful effects of TD on uptake of PMTCT services, though this mechanism did not appear to play a role for retention or viral suppression. Alternative approaches could be developed to address the effects of TD on HIV-related outcomes. <h3>Disclosure</h3> No significant relationships.