Evidence map›Paper›PMID 42576321›Full record

SynthesisJournal of the International AIDS Society2026

The Impact of Behavioural Economics-Informed Interventions on the Care Cascade for Sexually Transmitted and Blood-Borne Infections: A Systematic Review of Randomized Controlled Trials.

Min Zhao, Zhengcheng Tu, Xiang Zhao, Chunyan Li, Jiajun Sun, Ye Zhang, Warittha Tieosapjaroen, Fanpu Ji, Jason J Ong, Lei Zhang

Abstract readSystematic Review
In one paragraph

Synthesis in Journal of the International AIDS Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Min ZhaoPhase I clinical trial research ward, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.
Zhengcheng TuSchool of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Xiang ZhaoSecond Department of Coronary Heart Disease, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, People's Republic of China.
Chunyan LiTokyo College, The University of Tokyo, Tokyo, Japan.
Jiajun SunSchool of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Ye ZhangSchool of Public Health, Nanjing Medical University, Nanjing, People's Republic of China.
Warittha TieosapjaroenSchool of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Fanpu JiPhase I clinical trial research ward, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.
Jason J OngSchool of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Lei ZhangPhase I clinical trial research ward, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China.

Funding

Fundamental Research Funds for the Central Universities of China SK2026027Humanities and Social Sciences Research Project of the Ministry of Education of the People's Republic of China 24YJC840051Ministry of Science and Technology of the People's Republic of China 2022YFC2304900Ministry of Science and Technology of the People's Republic of China 2022YFC2304905National Key R&D Programme of China 2022YFC2505100National Key R&D Programme of China 2022YFC2505103Natural Science Foundation of Shaanxi Province 2025JC-YBQN-1106
6 · The paper itself

Abstract

introductionWhile behavioural economics principles are widely used for public health interventions, a comprehensive understanding of their impact across the sexually transmitted and blood-borne infections (STBBIs) care cascade remains limited. We systematically evaluated the effectiveness of behavioural economics-informed interventions for an STBBI care cascade.

methodsWe systematically searched five major literature databases from their inception to 25 April 2024, with the search updated on 22 March 2025. We included randomized controlled trials (RCTs) evaluating behavioural economics-informed interventions, that is strategies such as incentives, defaults, framing and reminders designed to influence health-related decision-making, at any stage of the care cascade for STBBIs. The cascade included three domains: prevention, care engagement and treatment adherence. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane RoB-2 tool. Due to significant heterogeneity, findings were synthesized narratively using a three-stage care cascade framework.

resultsOur search identified 2546 records, of which 40 RCTs met the inclusion criteria and evaluated 12 distinct behavioural economics-informed intervention types. Incentives were the most common intervention, including monetary, lottery and voucher-based incentives (25/40; 63%). Monetary and voucher incentives effectively improved outcomes across multiple cascade stages, including prevention (such as safer sex, male medical circumcision), care engagement (testing for HIV, HBV and HCV) and treatment adherence (such as retention in care, viral suppression). Opt-out defaults showed strong, sustained effects on HIV/HCV screening. Pay-it-forward strategies significantly increased dual STBBI testing and often demonstrated cost-effectiveness. A substantial proportion of studies (27/40; 67.5%) reported a high risk of bias. DISCUSSION: Behavioural economics-informed interventions showed stage-specific effects across the STBBI care cascade. Monetary incentives were the most consistently effective, especially for prevention, testing and some adherence outcomes. Defaults and pay-it-forward were promising for screening uptake, whereas crowdsourcing appeared more useful for intervention design. Overall, effectiveness depended on intervention design and context.

conclusionsBehavioural economics-informed interventions hold substantial promise for optimizing the STBBI care cascade, but no single strategy was universally optimal. Future research should strengthen the evidence base and assess the transferability of these interventions across diseases and context-specific settings to inform wider implementation and maximize global public health impact.

Indexed as

Blood-Borne InfectionsEconomics, BehavioralSexually Transmitted DiseasesAdherence InterventionsHumansRandomized Controlled Trials as Topicbehavioural economicsHIVincentivesnudgepay‐it‐forwardsexually transmitted and blood‐borne infections

Identifiers

PMID42576321
PMCPMC13458029

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.