Efficacy of a cell phone-based text messaging intervention in improving ART initiation, medication pick-up frequency, and retention in care amongst young adults living with HIV in Peru

• Autores: Calderón Flores, Rodrigo Alonso, Freidenson Bejar, Jeffrey Nathan
• Formato: tesis de grado
• Fecha de Publicación: 2021
• Institución: Universidad Peruana Cayetano Heredia
• Repositorio: UPCH-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorio.upch.edu.pe:20.500.12866/9011
• Enlace del recurso: https://hdl.handle.net/20.500.12866/9011
• Nivel de acceso: acceso abierto
• Materia: Infección por VIH; Retención en Cuidado; mHealth; Intervención con SMS; Perú; http://purl.org/pe-repo/ocde/ford#2.02.05; http://purl.org/pe-repo/ocde/ford#3.03.08

Background: Text messaging (SMS) interventions to improve HIV retention in care have shown mixed results, probably due to the diversity of features of their design and implementation. Methods: Using routinely collected data of the largest HIV program in Lima, we retrospectively evaluated the efficacy of an adapted single-arm, one-way SMS pilot intervention, intended to improve compliance with medical and ART pick-up appointments, by use of (i) SMS reminders before scheduled visits, (ii) a motivational SMS after scheduled visit, and (iii) phone calls after missed visits delivered for up to 9 months. The SMS group included people living with HIV (PLWH) ages 18-29 starting or restarting antiretroviral therapy (ART). For the control group, we non-randomly selected PLWH up to 35 years-old who were enrolled in the same HIV program within overlapping or closest dates to those of the SMS group (n = 320). The main outcomes, analyzed with multivariable adjusted models with follow-up closed by 18 months, were first year retention in care, ART initiation and medication pick-up frequency per three semesters. Results: First year retention in care was 61% in both groups (aRR: 1.01 [95% CI: 0.81-1.25]; p = 0.93); ART initiation was 83% (55/66) in the SMS-group and 79% (254/320) in the control group (aHR: 1.21 [95% CI: 0.89-1.62]; p = 0.23). Median number of ART pick-up visit during the first semester was 8 (IQR: 6-9) in the SMS group and 7 (IQR: 3-8) in the control group (aRR: 1.01 [95% CI: 0.81-1.25]; p = 0.93); in the following two semesters, we found no differences between the study groups. Conclusion: This pilot one-way SMS intervention tailored to young adult PLWH from a resource-constrained setting showed no strong effects across multiple HIV-care outcomes, all of which showed suboptimal results.