MOBILE PHONE TEXT MESSAGING FOR ADHERENCE TO ANTIRETROVIRAL THERAPY: APPROACHES TO EVIDENCE GENERATION AND SCALE UP

Abstract

Background and Objectives: HIV in a major public health problem in many countries of the world. Recent advances in care for people living with HIV such as the use of antiretroviral medication have reduced the mortality and morbidity associated with HIV infection. However, many people receiving antiretroviral therapy do not take it as prescribed and still experience sub-optimal health outcomes. Mobile phone text messaging is emerging as an important tool in health care, and HIV in particular. Our objectives were to explore the determining factors for adherence to antiretroviral therapy, test text messaging as an adherence enhancement tool, develop a framework for community ownership of a text messaging program and describe strategies for transfer of evidence in HIV to other conditions. Methods: This research is primarily based in Yaoundé, Cameroon, and employs a variety of methodologies, including a systematic review, two cross- sectional surveys, a randomized controlled trial, an individual patient data meta-analysis, a mixed methods study and a systematic review of systematic reviews. Results and Conclusions: Two-way weekly text messaging is an effective strategy in improving adherence to antiretroviral therapy and enhancing provider-client communication. People living with HIV in Yaoundé, Cameroon like receiving text messages, and are willing to own and run a text messaging program. Text messaging interventions may be transferred to other conditions by integrating services or by copying what works in HIV. Further research on potential harms, cost effectiveness and text messaging for other chronic conditions is warranted.