https://orcid.org/0000-0001-7438-7453
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ABSTRACT
Economic insecurity and poverty present major barriers to HIV care for young people. We conducted a systematic review of the current evidence for the effect of economic interventions on HIV care outcomes among pediatric populations encompassing young children, adolescents, and youth (ages 0–24). We conducted a search of PubMed MEDLINE, Cochrane, Embase, Scopus, CINAHL, and Global Health databases on October 12, 2022 using a search strategy curated by a medical librarian. Studies included economic interventions targeting participants <25 years in age which measured clinical HIV outcomes. Study characteristics, care outcomes, and quality were independently assessed, and findings were synthesized. Title/abstract screening was performed for 1934 unique records. Thirteen studies met inclusion criteria, reporting on nine distinct interventions. Economic interventions included incentives (n = 5), savings and lending programs (n = 3), and government cash transfers (n = 1). Study designs included three randomized controlled trials, an observational cohort study, a matched retrospective cohort study, and pilot intervention studies. While evidence is very limited, some promising findings were observed supporting retention and viral suppression, particularly for those with suboptimal care engagement or with detectable viral load. There is a need to further study and optimize economic interventions for children and adolescents living with HIV.
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Acknowledgements
We thank the Morris Green Physician Scientist Development Program, and the Pediatrics Department of the Indiana University School of Medicine, for supporting resident-directed research.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Author contributions
CBB and LAE designed the systematic review in conjunction with EF, who created the search strategy and identified appropriate databases. Title and abstract screening was conducted by CBB and MJA. CBB and JJT conducted the full text review, with supervisory contributions by LAE. CBB, JJT, and LAE reviewed all included studies and conducted data abstraction and synthesis of the evidence. CBB and LAE conducted the quality assessment. CBB drafted the initial manuscript. LAE and MSM provided significant revisions to the manuscript in structure and content. All authors participated in the revision of the manuscript and have read and approved the final manuscript.