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Description:Lotto to Link is an individual-level structural intervention with a conditional lottery incentive. Participants in intervention and comparison groups receive, during an initial inperson visit, an optimized ART linkage package, including a referral card and two-way text messages to support linkage to ART. In the first 3 months, all participants receive neutral, encouraging health promotional text messages with a number to text if additional help is needed. Participants in the intervention group only receive an additional immediate text message after visiting the clinic that provides information about entry into a lottery if they complete the next step in the HIV care continuum. One week later, another text message is sent to the intervention participants indicating the lottery result (win or not) and promoting additional opportunities to win the lottery. Lottery eligibility is conditional on clinical registration, ART initiation, completing ART monitoring and refill visits, and viral suppression at six months. Lottery prizes are either a mobile phone, data, or a gift card (all valued at South African Rand 1000/$100 US Dollars at the time of the study implementation). Staff provides information to the intervention group when a lottery is won and what prize is chosen.
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