It helps me live, sends my children to school, and feeds me: a qualitative study of how food and cash incentives may improve adherence to treatment and care among adults living with HIV in Tanzania

Lack of money is a barrier to HIV treatment and financial/in-kind incentives can improve outcomes in HIV treatment, but the mechanism of cash as an incentive is unclearn. This study unpacks the question of how financial incentives act to improve retention in care and ART adherence. Through in-depth interviews with clinic clients, found that the incentives acted through two primary pathways and one potential pathway to increase retention in care and adherence to ART: (1) addressing competing needs and offsetting opportunity costs associated with clinic attendance, (2) through a mental health pathway whereby the incentives reportedly alleviated stress associated with attending clinic, reduced worry about providing for oneself and one’s family, and provided hope for a better future, and (3) by potentially increasing motivation.