Headline
Contingency management interventions promote the prevention, diagnosis, and treatment of HIV, tuberculosis, and hepatitis in individuals with substance use disorder (SUD).
Background
Individuals with SUD are more likely to have co-occurring infectious diseases, such as hepatitis, HIV, and tuberculosis. Contingency management is an effective treatment for SUD. This literature review analyzed the breadth of studies available on contingency management and its effectiveness when applied to populations with SUD and HIV, tuberculosis, or hepatitis.
Findings
This literature review included 23 studies measuring contingency management programs in various treatment settings with different incentive structures. Rewarded behaviors related to: (1) prevention activities, such as receiving vaccinations for Hepatitis B; (2) targeting diagnosis activities, such as returning to a clinic within a required window for provider reading of tuberculosis skin test results; and (3) treatment activities, such as medication adherence among people diagnosed with tuberculosis or HIV. In 85% of the studies reviewed, contingency management improved adherence to medical services related to prevention (45%), diagnosis (54%), and treatment (20%) activities related to HIV, tuberculosis, and hepatitis, when compared to control groups.
Policy/Program Takeaways
Contingency management can be a valuable intervention for boosting adherence for preventive services, diagnostic tests, and treatment for HIV, tuberculosis, and hepatitis among people with SUD. Public health leaders and providers can use this review to apply contingency management to existing SUD programs seeking to improve outcomes for infectious disease.