Motivations, facilitators, and barriers of donation-based interventions in HIV and sexually transmitted infection research: a systematic review
An article in JAMA, published October 14, 2025.
Authors: Dorian Ho, Ye Liu, Jamie Conklin, Thomas Fitzpatrick, Jiayu Wang, Suzanne Day, Takhona G Hlatshwako, Rohit Ramaswamy, Ruby Congjiang Wang, Eneyi E Kpokiri, Weiming Tang, Elvin Geng, Joseph D Tucker
This systematic review explored donation-based interventions, such as giving out free HIV self-test kits, exchanging syringes among people who inject drugs, and "pay it forward" STI testing. These initiatives involve people receiving a free health service and then distributing or donating to support similar services for others. The review aimed to understand what motivates people to participate in these interventions, what helps or hinders them, and how these factors affect the success of the programs.
The study found that those distributing health services were primarily driven by a desire to help others and to build a sense of community. Social connections made it easier for them to share these services, as they could tailor their approach to each recipient and strengthen their peer relationships. However, in the case of secondary syringe exchange, there were some risks, such as potential legal issues and the burden of providing health care without professional oversight. Overall, the review suggests that these donation-based interventions leverage social networks to improve access to HIV/STI services among marginalized populations, highlighting the importance of fostering altruistic motivations and ensuring proper support for those involved in the distribution process.