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

机译：Empower Nudge彩票增加双重保护的使用：南非的概念验证随机试点试验

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The 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.
机译：这项研究的目的是基于行为经济学，以双重保护（同时使用有效的现代避孕方法和避孕套等隔离方法，同时使用避孕套）来预防艾滋病毒和其他性行为的方式，来衡量试点干预措施的初步功效。传播感染和意外怀孕。在2015年至2016年期间，Empower Nudge招募了100名年龄在18-40岁的女性在南非开普敦寻求堕胎后护理，这是一项随机对照试验，旨在测试旨在增加双重保护的彩票激励措施。基线时，参与者的平均年龄为27岁；其中82％来自南非； 58％的人自称是非洲黑人；平均完成学历为11.7年。在三个月的时间里，参加彩票干预与回访率更高（OR：6.0； 95％CI：2.45至14.7，p <0.01），安全套使用率更高（OR：4.5； 95％CI：1.43）到14.1; p <0.05）和更高的双重保护使用率（OR：3.16; 95％CI：1.01至9.9; p <0.05）。三个月后仅60％的研究人群返回，六个月后仅38％的人群返回。接受堕胎后护理的妇女代表了被忽视的人群，迫切需要艾滋病毒和预防怀孕。双重保护是这一人群至关重要的战略。基于彩票的行为经济学策略可能提供增加该人群双重保护使用的可能方式。需要进一步的研究以更大的样本，更长的暴露时间和更多的地点来建立彩票激励的双重保护的完全动力功效；使用客观验证进行监控。

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