Basic Income Guarantee Chicago: A Trial of Basic Income

In this R01, we intend to test the impact of basic income guarantee on the lives of young people living with HIV. The proposal will build off prior basic income guarantee programs in the city of Chicago such as the Chicago Resilient Communities Pilot. Our trial is among the first basic income guarantee interventions to test the impact of a basic income on clinic engagement and viral suppression. Other programs for people living with HIV have focused on conditional cash transfers, or fiscal remuneration for viral suppression or clinic engagement. Basic Income Guarantee Chicago uses a dignity-affirming approach which assumes that participants know best how to manage their income allotment and represents an unconditional cash transfer program. Young people living with HIV have the highest rates of HIV in the United States, and are the least to be retained in services for treatment and prevention of HIV, both of which are key components to Ending the HIV Epidemic. Multiple methodologies for engagement of young people living with HIV in care for HIV prevention and treatment success are required. Use of a dignity-affirming framework to support unconditional cash transfers over 18 months for young people living with HIV is a novel and innovative strategy for the improvement of social determinants of health. Therefore, this proposal will: 1) disperse basic income guarantee in $500 allotments using a randomized controlled trial compared to a treatment as usual group; 2) test the effect of basic income guarantee on viral suppression and clinic engagement, income volatility, and food insecurity; 3) examine whether housing, food security, transportation, employment, and mental health improvement moderate viral suppression; 4) explore the acceptability, feasibility, appropriateness, and potential impact of basic income guarantee on quality of life, education progress, and employment using in-depth-interviews; 5) measure potential spill-over effects within participants’ social networks; and 6) conduct a cost effectiveness analysis of basic income guarantee as a sustainable intervention for young people living with HIV. The body of work generated from this proposal will have major implications for engaging a key population in Getting to Zero efforts and has the potential to have important public health impacts for reducing rates of HIV in the United States. Without the prioritization of young people living with HIV, the United States will not end the HIV epidemic. If this basic income guarantee intervention is successful in improving clinic engagement, viral suppression, and/or quality of life metrics (mental health, employment, spill-over effects) for young people living with HIV, this work may have major policy implications beyond this proposal for provision of basic income guarantee to people living with HIV to mitigate the effects of social determinants of health for vulnerable populations who might benefit from an increased social safety net. Our multidisciplinary team of HIV preventionists, clinical psychologists, network epidemiologists, social interventionists, health economists, and cost-effectiveness experts is well positioned for the successful roll out of this trial which aims to provide basic income and learn how basic income guarantee augments the lives of young people living with HIV. Project Number: 1R01MH140688-01 | Fiscal Year: 2025 | NIH Institute/Center: National Institute of Mental Health (NIMH) | Principal Investigator: Jade Pagkas-Bather (+1 co-PI) | Institution: UNIVERSITY OF CHICAGO, CHICAGO, IL | Award Amount: $819,998 | Activity Code: R01 | Study Section: Population and Public Health Approaches to HIV/AIDS Study Section[PPAH] View on NIH RePORTER: https://reporter.nih.gov/project-details/11187483