Behaviourally-Informed Two-Way Text Messaging to Improve Return to HIV Care in South Africa: Evidence from a Randomised Controlled Trial.

IF 2.7 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

AIDS and Behavior Pub Date : 2025-07-11 DOI:10.1007/s10461-025-04808-6

Christine Njuguna, Preethi Mistri, Lawrence Long, Candice Chetty-Makkan, Brendan Maughan-Brown, Alison Buttenheim, Laura Schmucker, Sophie Pascoe, Harsha Thirumurthy, Cara O'Connor, Barry Mutasa, Kate Rees

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引用次数: 0

Abstract

One-way text messaging to re-engage people in HIV care has shown promise, but little is known about two-way messaging. We evaluated a behaviourally-informed two-way text messaging intervention to increase re-engagement in care following missed visits. We conducted an individual-level randomised controlled trial between February and March 2023 in Capricorn District, South Africa. Adults aged ≥ 18 years who had missed an ART visit by > 28 days were randomised to (1) a standard one-way text message, or (2) behaviourally-informed two-way text messages. The primary outcome was return to care within 45 days, analysed as (1) intention to treat, and (2) restricted to successful message delivery. 3,695 participants were randomised: 1,845 to the one-way message group and 1,850 to the two-way message group. 27.9% (515/1845) of participants sent a one-way message and 27.2% (503/1850) sent a two-way message returned for an ART visit within 45 days (proportion difference: -0.7%, p-value: 0.622). In an analysis restricted to participants whose text message was delivered, 28.3% (310/1094) in the one-way message group compared to 28.3% (304/1076) in the two-way message group returned to care (proportion difference: -0.09%, p-value: 0.966). 19.5% (210/1076) responded to the two-way message. The two most reported reasons for missed appointments were being out of town (41.0%) and still having medication (31.0%.). Behaviourally-informed two-way text messages did not improve return to care over one-way messages. However, they elicited reasons for disengagement. Additional research is needed on the mode, content and timing of two-way messages intended to increase return to care.Clinical Trial Number: PACTR202202748760768 & DOH-27-042022-6703. 28 February 2022.

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行为知情的双向短信提高南非艾滋病护理的回报：来自随机对照试验的证据。

单向短信使人们重新参与艾滋病毒护理已显示出希望，但对双向短信知之甚少。我们评估了一种行为知情的双向短信干预，以增加错过就诊后的再参与。我们于2023年2月至3月在南非摩羯座地区进行了一项个体水平随机对照试验。年龄≥18岁且错过ART治疗的成年人被随机分配到(1)标准的单向短信组，或(2)行为告知的双向短信组。主要结果是在45天内恢复护理，分析为(1)治疗意图，(2)仅限于成功的信息传递。3695名参与者被随机分配：1845人被分到单向消息组，1850人被分到双向消息组。27.9%（515/1845）的参与者发送了单向信息，27.2%（503/1850）的参与者发送了双向信息，在45天内返回ART访问（比例差：-0.7%，p值：0.622）。在一项仅限于发送短信的参与者的分析中，单向短信组的28.3%（310/1094）与双向短信组的28.3%（304/1076）相比（比例差异：-0.09%，p值：0.966）。19.5%（210/1076）回复了双向信息。错过预约最多的两个原因是出城（41.0%）和仍在服药（31.0%）。行为知情的双向短信与单向短信相比，并没有提高护理的回报。然而，他们引出了脱离接触的理由。需要对旨在增加护理回报的双向信息的模式、内容和时间进行进一步的研究。临床试验编号：PACTR202202748760768和DOH-27-042022-6703。2022年2月28日。

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来源期刊

AIDS and Behavior Multiple-

CiteScore

6.60

自引率

13.60%

发文量

382

期刊介绍： AIDS and Behavior provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews. provides an international venue for the scientific exchange of research and scholarly work on the contributing factors, prevention, consequences, social impact, and response to HIV/AIDS. This bimonthly journal publishes original peer-reviewed papers that address all areas of AIDS behavioral research including: individual, contextual, social, economic and geographic factors that facilitate HIV transmission; interventions aimed to reduce HIV transmission risks at all levels and in all contexts; mental health aspects of HIV/AIDS; medical and behavioral consequences of HIV infection - including health-related quality of life, coping, treatment and treatment adherence; and the impact of HIV infection on adults children, families, communities and societies. The journal publishes original research articles, brief research reports, and critical literature reviews.5 Year Impact Factor: 2.965 (2008) Section ''SOCIAL SCIENCES, BIOMEDICAL'': Rank 5 of 29 Section ''PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH'': Rank 9 of 76