Text Messaging for Improving Antiretroviral Therapy Adherence: No Effects After 1 Year in a Randomized Controlled Trial Among Adolescents and Young Adults

Sebastian Linnemayr, PhD, Haijing Huang, MA, Jill Luoto, PhD, Andrew Kambugu, M.Med, Harsha Thirumurthy, PhD, Jessica E. Haberer, MD, MS, Glenn Wagner, PhD, and Barbara Mukasa, MPH

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.

November 27, 2017
Year of publication
2017
Resource types
Journal and research articles
Tags
text message reminders, SMS-based interventions, ART adherence interventions, adherence, adherence support, antiretroviral therapy (ART), HIV-positive youth, adolescents, youth, young people, Uganda, behavior change

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