Doctor of Philosophy, The Ohio State University, 2019, Public Health

Introduction: Lifelong treatment for HIV-infected women offers profound benefits in terms of the prevention of mother-to-child transmission of HIV (PMTCT) and disease management, though poor adherence to antiretroviral drugs (ARV) and disengagement from PMTCT care can jeopardize these benefits. Insights from the field of behavioral economics reveal that high temporal discounting can lead to risky health behaviors, and these findings have informed the development of interventions, such conditional cash transfers (CCT), to mitigate these effects. Few studies, however, have directly assessed the effects of temporal discounting on behaviors relating to HIV prevention and treatment, and none have evaluated these effects among pregnant and breastfeeding women. Further, few studies have assessed the role of temporal discounting on the effect CCT or other similar interventions providing conditional economic incentives to improve behaviors relating to HIV treatment and prevention. Methods: We conducted a secondary analysis of data from a randomized controlled trial (RCT) conducted in Kinshasa, the Democratic Republic of Congo, which assessed the effect of a CCT intervention on retention in PMTCT care, adherence to ARV and viral suppression among newly-diagnosed HIV-infected pregnant women. We identified correlates of temporal discounting from health and demographic information collected at baseline. We then assessed the association between temporal discounting and retention in care at 6 weeks postpartum, uptake of available PMTCT services, and viral suppression at 6 weeks postpartum using log-binomial models to calculate unadjusted and adjusted RRs for high vs. low discounting for each outcome. We also evaluated possible interaction between temporal discounting and CCT for each outcome (retention, uptake of available PMTCT services and viral suppression). Results: High temporal discounting was associated with incomplete uptake of PMTCT services, and this effect was mitiga (open full item for complete abstract)

Committee: Abigail Norris Turner PhD (Advisor); Maria Gallo PhD (Committee Member); Abigail Shoben PhD (Committee Member); Marcel Yotebieng PhD, MD (Committee Member) Subjects: Economics; Epidemiology; Psychology; Public Health

Bachelor of Business Administration (BBA), Ohio University, 2014, Business Administration

Building on research on dynamic inconsistency and age related preferences; this paper introduces the concept that inconsistent intertemporal preferences are directly related to age. The findings from observations of a large sample of college graduates indicate that emerging adults are more likely to exhibit hyperbolic discounting behavior than adults over the age of 30. Among emerging adults respondents, lower incomes and more naive self-assessments are determinants of hyperbolic discounting behavior.

Committee: Julia Paxton (Advisor) Subjects: Behavioral Sciences; Economics