EFFECTS OF AN INCENTIVE AND EDUCATION-PROGRAM ON RETURN RATES FOR PPDTEST READING IN PATIENTS WITH HIV-INFECTION

To determine the impact of a food voucher incentive and patient educat ion program on compliance with tuberculin skin test (PPD, purified pro tein derivative) performance in HIV-infected adults, we analyzed retur n rates for PPD reading for patients at our urban HIV clinic. The grou ps studied included patients who received no intervention (controls), patients offered a food voucher incentive, and patients offered a food voucher and patient education intervention. Return rates for PPD read ing were 96 (35%) of 272 for the control group, 111 (48%, p = 0.004) o f 229 for the food voucher group, and 96 (61%, p < 0.0001) of 158 for the food voucher and patient education group. By univariate analysis, black patients (p = 0.01), males (p = 0.01), older patients (p = 0.004 ), city residents (p = 0.001), and injection drug users were more like ly to return for PPD reading. By logistic regression, food voucher, fo od voucher plus education, city residence, and male sex were significa ntly associated with return for PPD reading. Two simple, inexpensive i nterventions were found to increase compliance with tuberculin skin te st performance in HIV-infected adults. Additional interventions are re quired to achieve better rates of return for PPD reading.