Applying Behavioural Insights to HIV Prevention and Management: a Scoping Review

Abstract

Purpose of Review This scoping review summarises the literature on HIV prevention and management interventions utilizing behavioural economic principles encapsulated in the MINDSPACE framework. Recent Findings MINDSPACE is an acronym developed by the UK’s behavioural insights team to summarise nine key influences on human behaviour: Messenger, Incentives, Norms, Default, Salience, Priming, Affect, Commitment, and Ego. These effects have been used in various settings to design interventions that encourage positive behaviours. Currently, over 200 institutionalised behavioural insight teams exist internationally, which may draw upon the MINDSPACE framework to inform policy and improve public services. To date, it is not clear how behavioural insights have been applied to HIV prevention and management interventions. Summary After screening 899 studies for eligibility, 124 were included in the final review. We identified examples of interventions that utilised all the MINDSPACE effects in a variety of settings and among various populations. Studies from high-income countries were most common (n = 54) and incentives were the most frequently applied effect (n = 100). The MINDSPACE framework is a useful tool to consider how behavioural science principles can be applied in future HIV prevention and management interventions. Creating nudges to enhance the design of HIV prevention and management interventions can help people make better choices as we strive to end the HIV/AIDS pandemic by 2030.

Applications of Behavioral Economics to HIV Programs in Low and Middle Income Countries: A Scoping Review Using the EAST Framework

“…Because of limited resources and lack of sustainability, financial nudges are viewed as either not feasible, difficult to scale, or outside the range of program options by policy makers and program managers, the primary audience for this scoping review. Therefore financial nudges were excluded from this scoping review, but they are included in Andrawis et al 62…”

Self-driven solutions and resilience adapted by people with drug-resistant tuberculosis and their caregivers in Bengaluru and Hyderabad, India: a qualitative study

“…In-building intuitive information feedbacks and framing nudges within the person–caregiver interaction process, to reinforce person's perceptions on improvement of their physical health—however trivial—could unease treatment fatigue. 33 , 34 , 35 , 36 , 37 , 38 Gain framing approaches for developing communication messages for PwDR-TB could be a useful way forward. 39 Caregivers could positively reinforce the incremental milestones which persons have achieved through the treatment (e.g., increasing probability of cure, decreasing transmission risk for family members) to help ease their perception burden.…”

Are behavioral economics interventions effective in increasing colorectal cancer screening uptake: A systematic review of evidence and meta-analysis?

“…In one study, the authors concluded that compared to standard profit-based incentives, offering lottery incentives and losses framed incentives did not lead to a significant increase in HIV testing. However, when low-cost incentives are offered to promote HIV testing, designing lottery prizes may be a better approach than profit-based incentives [ 85 ]. Nudges can also have adverse consequences.…”