Effect of Text Message, Phone Call, and In-Person Appointment Reminders on Uptake of Repeat HIV Testing among Outpatients Screened for Acute HIV Infection in Kenya: A Randomized Controlled Trial

• Published in: PloS one Vol. 11; no. 4; p. e0153612
• Main Authors: Mugo, Peter M, Wahome, Elizabeth W, Gichuru, Evanson N, Mwashigadi, Grace M, Thiong'o, Alexander N, Prins, Henrieke A B, Rinke de Wit, Tobias F, Graham, Susan M, Sanders, Eduard J
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 14.04.2016; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; AIDS; Antigens; Appointments and Schedules; Biology and Life Sciences; Care and treatment; Clinical trials; Coasts; Confidence intervals; Diagnosis; Engineering and Technology; Female; Health facilities; HIV; HIV infections; HIV Infections - diagnosis; HIV tests; Human immunodeficiency virus; Humans; Infections; Kenya; Male; Management; Mass Screening - methods; Mass Screening - statistics & numerical data; Medical diagnosis; Medical research; Medical tests; Medicine; Medicine and Health Sciences; Outcome Assessment, Health Care - methods; Outcome Assessment, Health Care - statistics & numerical data; Outpatients - statistics & numerical data; Patient compliance; People and Places; Physical Sciences; Primary care; Randomization; Reminder Systems - statistics & numerical data; Seroconversion; Sexually transmitted diseases; Short message service; Statistical analysis; STD; Studies; Systematic review; Telephone - statistics & numerical data; Telephone calls; Text messaging; Text Messaging - statistics & numerical data; Young Adult; Kenya; United Kingdom
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0153612

Following HIV-1 acquisition, many individuals develop an acute retroviral syndrome and a majority seek care. Available antibody testing cannot detect an acute HIV infection, but repeat testing after 2-4 weeks may detect seroconversion. We assessed the effect of appointment reminders on attendance for repeat HIV testing. We enrolled, in a randomized controlled trial, 18-29 year old patients evaluated for acute HIV infection at five sites in Coastal Kenya (ClinicalTrials.gov NCT01876199). Participants were allocated 1:1 to either standard appointment (a dated appointment card) or enhanced appointment (a dated appointment card plus SMS and phone call reminders, or in-person reminders for participants without a phone). The primary outcome was visit attendance, i.e., the proportion of participants attending the repeat test visit. Factors associated with attendance were examined by bivariable and multivariable logistic regression. Between April and July 2013, 410 participants were randomized. Attendance was 41% (85/207) for the standard group and 59% (117/199) for the enhanced group, for a relative risk of 1.4 [95% Confidence Interval, CI, 1.2-1.7].Higher attendance was independently associated with older age, study site, and report of transactional sex in past month. Lower attendance was associated with reporting multiple partners in the past two months. Appointment reminders through SMS, phone calls and in-person reminders increased the uptake of repeat HIV test by forty percent. This low-cost intervention could facilitate detection of acute HIV infections and uptake of recommended repeat testing. Clinicaltrials.gov NCT01876199.