Study: Texting enhances HIV therapy compliance

Weekly mobile phone text messaging may help patients with human immunodeficiency virus (HIV) adhere to antiretroviral therapy (ART) that is often associated with difficult side effects, according to a study published online March 14 in the Cochrane Database of Systematic Reviews.

Tara Horvath of Global Health Sciences at the University of California, San Francisco, and colleagues noted that ART adherence is important for survival, to prevent drug resistance requiring a more expensive second-line regimen, and for suppressing viral load, which significantly reduces the likelihood of transmission.

High-quality evidence suggests that weekly text messages may enhance ART adherence, so investigators reviewed 2 randomized controlled trials from Kenya including a total of 966 adult patients with HIV. One trial compared short weekly text messages against standard care. The other trial compared short-daily, long-daily, short-weekly, and long-weekly messages against standard care.

Patients receiving standard care in each study received a mobile phone but did not receive any study-related mobile communication.

Those assigned to intervention in the first study were sent brief text messages, such as, “How are you?”, and were expected to respond within 48 hours. In the second study, patients assigned to intervention received daily or weekly short text messages, such as, “This is your reminder,” or daily or weekly long text messages, such as, “This is your reminder. Be strong and courageous. We care about you.”

At 48-52 weeks, combined data from both trials demonstrated that any text messaging was associated with greater ART adherence, weekly texts of any length were associated with adherence, and short weekly text messages were associated with adherence. In the first trial, short weekly texts were also associated with viral load suppression at 52 weeks.

Based on the quality of the evidence, the researchers concluded, “Policy-makers should consider funding programs proposing to provide weekly mobile phone text-messaging as a means for promoting adherence to antiretroviral therapy. Clinics and hospitals should consider implementing such programs.”