Text Messaging for Improving Antiretroviral Therapy Adherence

No Effects After 1 Year in a Randomized Controlled Trial Among Adolescents and Young Adults

Published in: American Journal of Public Health [Epub October 2017]. doi: 10.2105/AJPH.2017.304089

Posted on RAND.org on November 02, 2017

by Sebastian Linnemayr, Haijing Crystal Huang, Jill Luoto, Andrew Kambugu, Harsha Thirumurthy, Jessica Haberer, Glenn Wagner, Barbara Mukasa

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Objectives

To assess the effectiveness of Short Message Service (SMS) reminder messages on antiretroviral and cotrimoxazole prophylaxis adherence among HIV-positive youths as well as the relative effectiveness of SMS with and without a response option.

Methods

Eligible HIV-positive patients aged 15 to 22 years at 2 HIV clinics in Kampala, Uganda, participated in a year-long parallel individual-randomized controlled trial and were assigned in a 1-to-1-to-1 ratio to a weekly SMS message group, weekly SMS message with response option group, or a usual-care control group.

Results

We enrolled 332 participants. Electronically measured mean adherence was 67% in the control group, 64% in the 1-way SMS group (95% confidence interval [CI] = 0.77, 1.14), and 61% in the 2-way SMS group (95% CI = 0.75, 1.12) in an intent-to-treat analysis. Results for secondary outcomes and complete-case analysis were similarly statistically insignificant across groups.

Conclusions

Despite previous evidence that interventions using SMS reminders can promote antiretroviral therapy adherence, this study shows that they are not always effective in achieving behavior change. More research is needed to find out for whom, and under what conditions, they can be beneficial.

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