About

Harsha Thirumurthy, PhD, is the Founders Professor in Population Health at the University of Pennsylvania's Perelman School of Medicine. He serves as Associate Director of the Center for Health Incentives and Behavioral Economics Research, and is involved with the Population Studies Center and the Leonard Davis Institute of Health Economics as a Senior Fellow. Additionally, he is an Associate at the Population Aging Research Center and co-Director of the Behavioral Economics and Global Health Insights Lab. His department is Medical Ethics and Health Policy, and he is affiliated with the Graduate Group in Demography. His educational background includes a BA in Economics and Physics from Oberlin College, and advanced degrees in Economics from Yale University, culminating in a PhD in Economics. His research focuses on health economics, behavioral economics, and population health, with particular interest in HIV prevention, maternal and child health, and health behavior change. Thirumurthy has contributed to understanding the impact of financial incentives on health behaviors, the effectiveness of cash transfer programs in improving health outcomes, and addressing misinformation related to HIV vaccines. His work involves developing interventions and policies aimed at improving health outcomes in global populations, especially in low-income settings.

Research topics

• Medicine
• Family medicine
• Political Science
• Psychology
• Internal medicine
• Public administration
• Pediatrics
• Psychiatry
• Nursing
• Clinical psychology
• Law
• Medical emergency
• Virology
• Gerontology

Selected publications

• Engaging Community and Healthcare Stakeholders in the Design of HIV Retesting Messages: Findings from Human-Centered Design Workshops in Kenya and Uganda

  medRxiv · 2026-05-04

  articleOpen accessSenior author

  Frequent HIV testing, or "retesting," the practice of regular HIV testing following a negative test result, among persons at high risk of HIV exposure is critical for initiating treatment early among newly infected persons and reducing the risk of HIV transmission. However, barriers to HIV retesting, such as fear of stigma, underestimating risk after a prior negative HIV test, and navigating the logistics of accessing an HIV test, have contributed to lower-than-desired retesting rates in Sub-Saharan Africa, where median time from infection to diagnosis is over 2.5 years. The Innovative Behavioral Intervention Strategies (IBIS) study aims to encourage re-testing by utilizing principles of behavioral economics and human-centered-design in a many-arm randomized trial (known as a "megatrial") of avatar-delivered video-based messages and text messages to promote HIV retesting. In 2025, we conducted two-day focus groups in Kenya and Uganda to prototype the messages among community members and healthcare workers. An expert team engaged participants in various activities and discussions to elicit their feedback, where they reflected on factors such as local relevance, clarity, and visual appeal for each prototype. Key changes as a result of workshop feedback include standardized greetings for each arm, clearer language and refined translations, SMS language which protects participant privacy, and avatar updates for local acceptability, while maintaining core behavioral theory. The workshops generated important insights that shaped the final avatars, scripts, and messages encouraging HIV retesting which will be incorporated in the eventual trial. This study demonstrates the value of engaging end-users early in the intervention development process, and gives insight into the application of artificial intelligence (AI) to improve health behaviors in resource-limited settings.

  PublisherDOI

• Hazardous alcohol use is associated with sexual behaviors that increase risk for HIV acquisition among fishermen in a high HIV prevalence area of Kenya

  AIDS Care · 2026-03-17

  articleOpen access

  Links between hazardous alcohol use and HIV acquisition are well documented, with less known about this relationship among fishermen, a priority group for HIV prevention. We examined associations between hazardous alcohol use and sexual risk behaviors among fishermen in Kenya using 2022 data from 733 fishermen in three Lake Victoria communities. Measures included the AUDIT-C and sexual relationship histories. Logistic regression models assessed associations between hazardous alcohol use and (1) any concurrent sexual relationships, (2) concurrency among non-polygynous men, (3) any higher HIV risk sexual relationships, and (4) higher HIV risk sexual relationships among non-polygynous men in past six months, controlling for covariates and clustering. Among 713 sexually active men. PrEP (8%) and condom use (<5%) were low; 16% reported hazardous alcohol use. Hazardous alcohol use was associated with greater odds of concurrency (aOR = 1.38, 95%CI: 0.96-1.98), though not statistically significant. Among non-polygynous men, hazardous alcohol use was significantly associated with concurrency (aOR = 1.74, 95%CI:1.18-2.56). No association was observed with higher-risk relationships among all men (aOR = 1.72, 95%CI:0.91-3.25) and among non-polygynous men (aOR = 1.67, 95%CI:0.84-3.34). Hazardous alcohol use is linked to sexual behaviors that heighten HIV risk and support integrating alcohol risk reduction into HIV prevention strategies for fishermen in East Africa.

  PublisherDOI

• Increasing HIV treatment literacy among people living with HIV using a novel health communication aid: Evidence from KwaZulu Natal province, South Africa.

  2025-09-29

  preprint
  PublisherDOI

• Gaps in Effective HIV Pre-exposure Prophylaxis Screening and Uptake Among Fishermen in Kenya

  AIDS and Behavior · 2025-11-18

  articleOpen access

  Despite oral daily HIV pre-exposure prophylaxis (PrEP) effectiveness, uptake remains a challenge. Awareness of one's HIV status and engagement in prevention is essential to interrupting transmission among populations at high risk of HIV. We explored gaps in HIV risk perception, screening, and PrEP uptake among high HIV-risk fishermen living and working along Lake Victoria, Kenya. Data are from the Owete study (NCT04772469), which evaluated the impact of secondary distribution of HIV self-tests and supported linkage to health facilities within social-networks on prevention engagement. Using self-reported sexual behavior data and clinical records, we (1) identified PrEP-eligible men based on self-reported sexual behavior, per Kenya national guidelines; (2) reported the proportion of fishermen who (a) linked to a healthcare facility post-testing, (b) initiated PrEP per clinic records; and 3) analyzed the relationship between PrEP eligibility and perceived HIV risk using logistic regression, controlling for socio-demographic characteristics. Among 733 fishermen, 715 were sexually active in the past 6 months. The median age was 37.2, 68.4% had ≤ primary education, and 87% were married. PrEP eligibility was prevalent (474; 65%); of eligible men, 222 (47%) linked to a healthcare facility after testing, of whom 127 (57%) received a confirmatory HIV test, 31 (14%) initiated PrEP and 2 (0.1%) were already on PrEP. Primary reasons for non-initiation include screening as low risk at the facility (n = 66; 30%), declining PrEP (n = 41; 18%), and stock-outs (n = 5; 2%). Participants reporting moderate or high self-perceived HIV acquisition risk had 1.80 (95% CI: 1.09, 2.98, p = 0.023) and 1.75 (95% CI: 1.01, 3.03, p = 0.045) times the risk of screening as PrEP eligible, respectively, compared to those reporting no risk. A substantial proportion of fishermen were eligible for PrEP based on sexual behaviors self-reported during the study surveys which align with standardized PrEP eligibility criteria. Nevertheless, we identified a high discordance between these self-reported criteria which renders one PrEP eligible and actually screening PrEP-eligible at a healthcare facility, highlighting potential gaps in effective screening for and subsequent coverage of PrEP to men at risk for HIV acquisition. Understanding the potential limitations of current PrEP screening protocols, as well as clients' experiences with PrEP screening in the clinic, may increase the sensitivity of PrEP screening and close gaps in effective PrEP coverage.Clinical Trial Registration: NCT04772469.

  PublisherOA PDFDOI

• Effectiveness of Financial Incentives for Health Behavior Change: A Narrative Review and Analysis

  Annual Review of Public Health · 2025-12-23

  article

  Financial incentives have been widely studied and implemented as instruments to encourage healthy behavior. This narrative expert review synthesizes evidence from 39 systematic, meta-analytic, narrative, and scoping reviews examining incentive-based interventions for four health behaviors: physical activity, smoking cessation, vaccination, and medication adherence. The reviewed studies encompass a wide range of populations and contexts, though the evidence is primarily in high-income settings, with less representation from low- and middle-income countries. Across domains, financial incentives tend to produce modest, often short-lived improvements; greater effectiveness is observed when incentives are substantial, promptly delivered, and contextually tailored and when behavioral outcomes are tracked using objective measures. Targeted incentives may reduce disparities in health behavior, though their ethical and social acceptability merit careful consideration. Gaps in the literature include short follow-up windows and limited cost-effectiveness data. Future research should probe long-term outcomes, explore heterogeneity of response to better understand mechanisms of sustained change, and study the effects of nonfinancial or social incentives.

  PublisherDOI

• Alcohol use and HIV suppression after completion of financial incentives for alcohol abstinence and isoniazid adherence: a randomized controlled trial

  EClinicalMedicine · 2025-01-08

  articleOpen access

  Background: In a recent randomized trial, six months of financial incentives contingent for recent alcohol abstinence led to lower levels of hazardous drinking, while incentives for recent isoniazid (INH) ingestion had no impact on INH adherence, during TB preventive therapy among persons with HIV (PWH). Whether the short-term incentives influence long-term alcohol use and HIV viral suppression post-intervention is unknown. Methods: We analyzed twelve-month HIV viral suppression and alcohol use in the Drinkers' Intervention to Prevent Tuberculosis study, a randomized controlled trial among PWH with latent TB and unhealthy alcohol use in south-western Uganda. We randomly assigned 680 participants (1:1:1:1) initiating six months of INH to: Arm 1, no incentives (control); Arm 2, financial incentives contingent on recent alcohol abstinence; Arm 3, incentives contingent on recent INH use; and Arm 4, incentives for recent alcohol abstinence and INH use, rewarded separately. The 6 months post-intervention outcomes evaluated were pre-specified and included: HIV viral suppression (<200 copies/mL) and no/low alcohol use, defined as Alcohol Use Disorders Identification Test-Consumption negative (<3: women, <4: men) and phosphatidylethanol, an alcohol biomarker, <35 ng/mL. We estimated adjusted risk differences (aRD) for alcohol reduction and INH adherence interventions using multivariable logistic regression adjusting for randomization stratification factors (sex and study site), and baseline alcohol use (alcohol intervention model only). Clinicaltrials.gov registration: NCT03492216, Registered 04/10/2018. Findings: Of 600 participants with 12-month viral load results, 556/585 (95%) with baseline results were virally suppressed, and 583/600 (97%) were virally suppressed at 12-months. Twelve-month viral suppression did not differ significantly between either intervention group versus control (alcohol reduction incentives versus control aRD = -0.9% (95% CI: -3.6 to 1.7); INH adherence incentives versus control aRD = 2.2% (95% CI: -0.4 to 4.9)). Of the 617 participants with 12-month alcohol use measures, alcohol reduction incentives led to a significantly greater proportion with no/low alcohol use at 12-months (20.2% [64/317]) versus no alcohol reduction incentives (11.0% [33/300]); aRD = 8.4%, (95% CI: 3.3-13.4), p = 0.001. Interpretation: Viral suppression was high (>95%) at baseline and at 12 months: we found no effect of either 6-month alcohol reduction or INH adherence incentives on long-term viral suppression. Six months of alcohol reduction incentives were effective at promoting no/low alcohol use at 12 months, demonstrating persistent effects post-intervention. Funding: National Institutes of Health (NIH/NIAAA) U01AA026223 (PI: Hahn) and U01AA026221 (PI: Chamie), NIH/NIAAAK24 AA022586 (PI: Hahn), NIH/NIAAAK24 AA031211 (PI: Chamie), Providence/Boston Center for AIDS ResearchP30AI042853 (PI: Sara Lodi).

  PublisherDOI

• B-OK: a visual and tactile tool for improving HIV mental models in a United States urban center

  AIDS Care · 2025-02-04

  articleOpen access

  = 85). B-OK was associated with improved awareness and understanding of HIV terminology, changes in HIV treatment attitudes, and increased intention to rely on HIV treatment for transmission prevention. Qualitative interview results aligned with the quantitative findings. These findings provide a strong rationale to further evaluate the potential for B-OK to improve HIV treatment adherence support.

  PublisherOA PDFDOI

• The Coach Mpilo Study: evaluation of a peer-led intervention to promote engagement in HIV care for men living with HIV in South Africa

  AEA Randomized Controlled Trials · 2025-10-27

  datasetSenior author
  PublisherDOI

• The Coach Mpilo Study: evaluation of a peer-led intervention to promote engagement in HIV care for men living with HIV in South Africa

  AEA Randomized Controlled Trials · 2025-10-27

  datasetSenior author
  PublisherDOI

• Money, Medicine, and Motherhood: Developing a Cash Transfer for Pregnant Women with HIV in Rural Haiti

  AIDS and Behavior · 2025-11-06

  articleOpen access

  Improving perinatal engagement in HIV care is critical to prevent disease progression and transmission. In Haiti and other low-resource settings, poverty contributes substantially to poor perinatal HIV outcomes. Cash transfers are a promising intervention that may alleviate poverty and improve perinatal HIV outcomes through economic and psychological pathways. To inform the design of an unconditional cash transfer intervention, we conducted semi-structured interviews with 20 pregnant and postpartum women with HIV receiving care at St. Boniface Hospital in rural Haiti 12/2023-5/2024. Using an interview guide with open-ended questions, we explored barriers and facilitators to HIV care around the time of birth and perspectives on and preferred features of a potential unconditional cash transfer. Interviews were conducted in Haitian Creole, transcribed and translated into English, and analyzed thematically using a codebook developed through deductive and inductive coding. Participants (median age 24 years; 50% pregnant) described barriers including antiretroviral therapy side effects, particularly when taken without food, interpersonal stigma, poverty, and food insecurity. Facilitators included motivation to protect the child's health, understanding treatment benefits, transportation reimbursement, and social support. Participants viewed cash transfers as a promising way to address poverty-related barriers, reporting they would use funds for household needs, child expenses, and small business activities. Preferred transfer sizes varied, as did preferences about delivery, timing, and frequency. Findings underscore poverty's central role in shaping perinatal HIV care engagement and support the potential of unconditional cash transfers to improve outcomes.

  PublisherOA PDFDOI

Recent grants

• NIH Grant K01HD061605

  NIH · $638k · 2017

• Secondary distribution of HIV self-tests: an innovative strategy for promoting male partner testing and reducing risk

  NIH · $3.2M · 2016–2022

• NIH Grant R01MH105254

  NIH · $3.0M · 2021

Frequent coauthors

• Joshua Graff Zivin

  National Bureau of Economic Research

  85 shared

• Markus Goldstein

  World Bank

  75 shared

• Gabriel Chamie

  University of California, San Francisco

  68 shared

• Diane V. Havlir

  University of California, San Francisco

  64 shared

• Bienvenu Kawende

  University of Kinshasa

  60 shared

• Moses R. Kamya

  Makerere University

  58 shared

• Audrey Pettifor

  University of North Carolina at Chapel Hill

  54 shared

• Abigail B. Shoben

  The Ohio State University

  52 shared

Labs

• Behavioral Economics and Global Health Insights LabPI

Education

• B.A., Economics & Physics

  Oberlin College

  1998

• M.A., Economics

  Yale University

  2002

• Other, Economics

  Yale University

  2003

• Ph.D., Economics

  Yale University

  2006