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Text messaging for improving antiretroviral therapy adherence: No effects after 1 year in a randomized controlled trial among adolescents and young adults

Author

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  • Linnemayr, S.
  • Huang, H.
  • Luoto, J.
  • Kambugu, A.
  • Thirumurthy, H.
  • Haberer, J.E.
  • Wagner, G.
  • Mukasa, B.

Abstract

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.

Suggested Citation

  • Linnemayr, S. & Huang, H. & Luoto, J. & Kambugu, A. & Thirumurthy, H. & Haberer, J.E. & Wagner, G. & Mukasa, B., 2017. "Text messaging for improving antiretroviral therapy adherence: No effects after 1 year in a randomized controlled trial among adolescents and young adults," American Journal of Public Health, American Public Health Association, vol. 107(12), pages 1944-1950.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2017.304089_2
    DOI: 10.2105/AJPH.2017.304089
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    Cited by:

    1. Talitha Crowley & Charné Petinger & Azia Ivo Nchendia & Brian van Wyk, 2023. "Effectiveness, Acceptability and Feasibility of Technology-Enabled Health Interventions for Adolescents Living with HIV in Low- and Middle-Income Countries: A Systematic Review," IJERPH, MDPI, vol. 20(3), pages 1-18, January.
    2. Ditte S Linde & Malene Korsholm & Johnson Katanga & Vibeke Rasch & Andreas Lundh & Marianne S Andersen, 2019. "One-way SMS and healthcare outcomes in Africa: Systematic review of randomised trials with meta-analysis," PLOS ONE, Public Library of Science, vol. 14(6), pages 1-18, June.
    3. Franklin I Onukwugha & Lesley Smith & Dan Kaseje & Charles Wafula & Margaret Kaseje & Bev Orton & Mark Hayter & Monica Magadi, 2022. "The effectiveness and characteristics of mHealth interventions to increase adolescent’s use of Sexual and Reproductive Health services in Sub-Saharan Africa: A systematic review," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-18, January.
    4. Caryl Feldacker & Isaac Holeman & Vernon Murenje & Sinokuthemba Xaba & Michael Korir & Bill Wambua & Batsirai Makunike-Chikwinya & Marrianne Holec & Scott Barnhart & Mufuta Tshimanga, 2020. "Usability and acceptability of a two-way texting intervention for post-operative follow-up for voluntary medical male circumcision in Zimbabwe," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-18, June.

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