Njuguna Christine, Mistri Preethi, Long Lawrence, Chetty-Makkan Candice, Maughan-Brown Brendan, Buttenheim Alison, Schmucker Laura, Pascoe Sophie, Thirumurthy Harsha, O'Connor Cara, Mutasa Barry, Rees Kate
Anova Health Institute, 12 Sherborne Road, Parktown, Johannesburg, 2193, South Africa.
Health Economics and Epidemiology Research Office, Wits Health Consortium, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
AIDS Behav. 2025 Jul 11. doi: 10.1007/s10461-025-04808-6.
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.
通过单向短信促使人们重新参与艾滋病护理已显示出前景，但对于双向短信却知之甚少。我们评估了一种基于行为学的双向短信干预措施，以提高错过就诊后重新参与护理的比例。2023年2月至3月，我们在南非摩羯座地区开展了一项个体层面的随机对照试验。年龄≥18岁且错过抗逆转录病毒治疗就诊超过28天的成年人被随机分为两组：（1）标准单向短信组，或（2）基于行为学的双向短信组。主要结局是在45天内恢复护理，分析方式为：（1）意向性分析，以及（2）仅限于成功发送短信的情况。3695名参与者被随机分组：1845人进入单向短信组，1850人进入双向短信组。发送单向短信的参与者中有27.9%（515/1845），发送双向短信的参与者中有27.2%（503/1850）在45天内返回接受抗逆转录病毒治疗（比例差异：-0.7%，p值：0.622）。在仅限于短信已发送成功的参与者的分析中，单向短信组中有28.3%（310/1094）返回接受护理，双向短信组中有28.3%（304/1076）返回接受护理（比例差异：-0.09%，p值：0.966）。19.5%（210/1076）回复了双向短信。错过预约最常报告的两个原因是外出（41.0%）和仍有药物（31.0%）。基于行为学的双向短信在促使重新接受护理方面并未比单向短信有更好的效果。然而，它们引出了脱离护理的原因。需要对旨在提高重新接受护理比例的双向短信的模式、内容和时间安排进行更多研究。临床试验编号：PACTR202202748760768 & DOH-27-042022-6703。2022年2月28日。
