# Poverty, Mental Bandwidth, and an Unconditional Cash Transfer Intervention to Enable Health Behaviors for Pregnant People with HIV

> **NIH NIH K23** · UNIVERSITY OF PENNSYLVANIA · 2022 · $192,824

## Abstract

PROJECT SUMMARY
Candidate: I am a Fellow in Infectious Diseases at the University of Pennsylvania and a physician-scientist
with a Master of Public Health degree and 5 years of experience working in rural Haiti. While I have a strong
track record of published research at the intersection of poverty, food security, and infectious diseases, my
experiences have motivated me to shift my research in two ways. First, I have developed an interest in
poverty's effects on decision-making, including the theory of poverty's psychological impacts, the empirical
measures of these impacts, and the scientific approaches used to examine the effects of poverty alleviation on
health behaviors and outcomes. Second, I plan to move from observational work towards the design and
execution of hybrid effectiveness-implementation clinical trials of innovative economic interventions to improve
HIV outcomes. Background: Poverty is an important contributor to poor short- and long-term HIV outcomes
for pregnant people with HIV (PrPWH). This problem is particularly salient in Haiti, where 25% of people live in
extreme poverty and only half of PrPWH are retained in care 12 months after starting ART. Recent research in
behavioral economics has shown that poverty can result in worse health outcomes by taxing mental
bandwidth, resulting in a heightened focus on immediate needs and less attention to future-oriented decisions.
Mental bandwidth is likely further taxed by the added burdens of HIV and the perinatal period. Consequently,
anti-poverty interventions targeting PrPWH may be particularly effective at improving health outcomes.
Training: To achieve research independence, I require additional training in 1) behavioral economics and the
decision-making processes underlying health behaviors; 2) the conduct and analysis of qualitative studies; and
3) hybrid effectiveness-implementation clinical trials. Mentors: My training and research plans will be overseen
by Dr. Harsha Thirumurthy, who has extensive mentoring experience and expertise in developing and testing
economic interventions to improve HIV outcomes. Drs. Louise Ivers (research in rural Haiti, qualitative design),
Florence Momplaisir (implementation science, qualitative design, PrPWH), and Heather Schofield (mental
bandwidth measures in poverty) will be additional co-mentors, and Drs. Christophe Millien (PrPWH in Haiti)
and Alisa Stephens-Shield (biostatistics) will be advisors. Research: I will use 3 aims to accomplish my
objective of assessing a key pathway — mental bandwidth — by which poverty (and cash transfers to combat
poverty) can affect health behaviors among PrPWH in rural Haiti: 1) Characterize the relationship between
mental bandwidth, HIV, and the perinatal period; 2) Identify key characteristics of an unconditional cash
transfer intervention for PrPWH; and 3) Conduct a Hybrid Type 2 effectiveness-implementation trial of an
unconditional cash transfer intervention for PrPWH. This research will be conducted ...

## Key facts

- **NIH application ID:** 10548558
- **Project number:** 1K23MH131464-01
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** Aaron G Richterman
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $192,824
- **Award type:** 1
- **Project period:** 2022-08-01 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10548558

## Citation

> US National Institutes of Health, RePORTER application 10548558, Poverty, Mental Bandwidth, and an Unconditional Cash Transfer Intervention to Enable Health Behaviors for Pregnant People with HIV (1K23MH131464-01). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10548558. Licensed CC0.

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