Retrospective Cohort Study of Financial Incentives for Sexually Transmitted Infection Testing and Treatment in an Outreach Population in Edmonton, Canada, 2018–2019
Bibliographic record
Abstract
BACKGROUND: The incidence of sexually transmitted infections (STI) continues to increase worldwide. Patient incentives are one proposed intervention to increase STI testing and treatment. METHODS: We conducted a retrospective cohort study comparing incentivized versus routine care for STI outreach test and treat services between October 2018 and June 2019. Incentivized care included a $10 gift card for testing visits and an additional $10 gift card for results and/or treatment visits. Incentivized visits were offered to clients with a lack of housing, who were difficult to locate, or had a history of being lost to follow-up. All test and treatment visits included chlamydia, gonorrhea, syphilis, and HIV testing and/or treatment by Registered Nurses and outreach workers from an STI Clinic. Outreach visits were offered at subsidized housing locations, community-based organizations, and street outreach. RESULTS: From October 2018 to June 2019, 2384 outreach clients were reached: 453 (19.0%) received incentives and 1931 (81.0%) received routine care. There were no significant differences in case-finding rates for chlamydia (4.8%), gonorrhea (2.9%), and HIV (0.1%); however, there was for syphilis (3.8% for incentivized vs. 1.9% for routine visits; P = 0.02). All newly diagnosed infections identified in the incentivized group received treatment compared with routine visits (chlamydia 100% vs 79.1%, P = 0.008, gonorrhea 100% vs 59.7%, P = 0.002, and syphilis 100% vs. 86.7%, P = 0.08). CONCLUSIONS: Incentives were associated with increased case-finding rates of syphilis and were associated with 100% treatment rates. Incentives are a promising approach to decreasing the burden of STI among outreach populations.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".