Monthly unconditional cash payments for pregnant women with HIV in Botswana
A Pilot Trial of an Unconditional Cash Transfer for Pregnant Women With HIV in Botswana
This pilot will test whether giving monthly unconditional cash payments to economically vulnerable pregnant women with HIV in Botswana helps them keep taking HIV medicines and remain in care through the postpartum period.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 100 (estimated) |
| Ages | 18 Years and up |
| Sex | Female |
| Sponsor | University of Pennsylvania Academic / other |
| Locations | 3 sites (Gaborone and 2 other locations) |
| Trial ID | NCT07226492 on ClinicalTrials.gov |
What this trial studies
This pilot Hybrid Type 2 effectiveness–implementation trial will deliver unconditional cash transfers (UCTs) to pregnant women with HIV attending selected public antenatal clinics in Gaborone and the Mogoditsane‑Thamaga District. The intervention will be delivered via mobile money and outcomes will include mental bandwidth, ART adherence measured by proportion of days covered (PDC) during pregnancy and postpartum, and retention in care after delivery. The trial pairs effectiveness measurement with implementation research, using quantitative adherence and retention data plus qualitative work to assess feasibility, acceptability, and barriers to scaling. Findings will inform adaptation for a larger trial or a policy pilot such as a pregnancy support grant.
Who should consider this trial
Good fit: Ideal participants are Botswana citizens aged 18 or older who are confirmed pregnant at under 20 weeks gestation, HIV‑positive, economically vulnerable (below the Botswana poverty line), and seeking antenatal care at participating public clinics in Gaborone or Mogoditsane‑Thamaga.
Not a fit: People unlikely to benefit include those who are not economically vulnerable, are beyond the gestational age window, cannot use mobile money or provide informed consent, or are already consistently adherent and retained in care.
Why it matters
Potential benefit: If successful, monthly cash transfers could increase mental bandwidth, improve ART adherence during pregnancy and postpartum, and increase retention in HIV care, potentially improving maternal and infant health outcomes.
How similar studies have performed: Prior cash‑transfer research has shown mixed results—some behavioral studies suggest benefits for decision‑making and health behaviors, while trials like HPTN068 found no reduction in HIV incidence in a different population—so this application is partly novel and context‑specific.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * Age 18 years or greater * Botswana citizen * Seeking/receiving antenatal care at antenatal clinics managed by the District Health Management Teams in Gaborone and Mogoditsane-Thamaga District * Confirmed pregnancy by standard laboratory methods (generally urine testing) * \<20 weeks gestational age (by ultrasound dating) * HIV seropositive * Economically vulnerable (self-reported annual income below the Botswana poverty line of 14,000 BWP per year, equivalent to the international poverty line of $2.15 in 2017 purchasing power parity) Exclusion Criteria: * Does not meet all of the inclusion criteria * Unable to provide consent * Cognitive impairment, per discretion of study staff * Cannot be in the same household as another enrolled study participant
Where this trial is running
Gaborone and 2 other locations
- Lesirane Clinc — Gaborone, Botswana (Not_yet_recruiting)
- Mafitlhakgosi Clinic — Gaborone, Botswana (Not_yet_recruiting)
- Old Naledi Clinic — Gaborone, Botswana (Recruiting)
Study contacts
- Study coordinator: Aaron G Richterman, MD, MPH
- Email: Aaron.Richterman@Pennmedicine.upenn.edu
- Phone: 267-441-7915
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.