A Systematic Review of Interventions that Promote Frequent HIV Testing

Paschen-Wolff, Margaret M.; Restar, Arjee; Gandhi, Anisha D.; Serafino, Stephanie; Sandfort, Theodorus

doi:10.1007/s10461-019-02414-x

Cited by 27 publications

(23 citation statements)

References 51 publications

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“…For example, SMS‐based interventions have been found effective in improving adherence to antiretroviral therapy in HIV‐infected people [8] and WHO recommend their use in this context [7]. SMS reminders also have the potential to increase the uptake of frequent HIV testing in uninfected at‐risk individuals [9]. However, previous studies had limitations: they either were observational [10‐12] or assessed the effect of sending SMS reminders to retest participants presenting with a suspected acute HIV infection one month after a first negative test, a very specific situation [13].…”

Section: Introductionmentioning

confidence: 99%

Appointment reminders to increase uptake of HIV retesting by at‐risk individuals: a randomized controlled study in Thailand

et al. 2020

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Introduction Frequent HIV testing of at‐risk individuals is crucial to detect and treat infections early and prevent transmissions. We assessed the effect of reminders on HIV retesting uptake. Methods The study was conducted within a programme involving four facilities providing free‐of‐charge HIV, syphilis and hepatitis B and C testing and counselling in northern Thailand. Individuals found HIV negative and identified at risk by counsellors were invited to participate in a three‐arm, open‐label, randomized, controlled trial comparing: (a) “No Appointment & No Reminder” (control arm); (b) “No Appointment but Reminder”: short message service (SMS) sent 24 weeks after the enrolment visit to remind booking an appointment, and sent again one week later if no appointment was booked; and (c) “Appointment & Reminder”: appointment scheduled during the enrolment visit and SMS sent one week before appointment to ask for confirmation; if no response: single call made within one business day. The primary endpoint was a HIV retest within seven months after the enrolment visit. The cost of each reminder strategy was calculated as the sum of the following costs in United States dollars (USD): time spent by participants, counsellors and hotline staff; phone calls made; and SMS sent. The target sample size was 217 participants per arm (651 overall). Results Between April and November 2017, 651 participants were randomized. The proportion presenting for HIV retesting within seven months was 11.2% (24/215) in the control arm, versus 19.3% (42/218) in “No Appointment but Reminder” (p = 0.023) and 36.7% (80/218) in “Appointment & Reminder” (p < 0.001). Differences in proportions compared to the control arm were respectively +8.1% (95% CI: +1.4% to +14.8%) and +25.5% (+17.9% to +33.2%). The incremental cost‐effectiveness ratios of “No Appointment but Reminder” and “Appointment & Reminder” compared to the control arm were respectively USD 0.05 and USD 0.14 per participant for each 5% increase in HIV retesting uptake within seven months. Conclusions Scheduling an appointment and sending a reminder one week before was a simple, easy‐to‐implement and affordable intervention that significantly increased HIV retesting uptake in these at‐risk individuals. The personal phone call to clients probably contributed, and also improved service efficiency.

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Section: Introductionmentioning

confidence: 99%

Appointment reminders to increase uptake of HIV retesting by at‐risk individuals: a randomized controlled study in Thailand

et al. 2020

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“…Previous studies globally evaluating the effect of SMS in promotion of patient care not only in HIV but other illnesses have also found this method to improve compliance with care (7,8,(11)(12)(13)(14)(15)(16)(17). A 2017 systemic review by Daher et al including 99 studies in Africa, Asia, Europe and America assessed whether digital innovations were feasible, acceptable and had a general impact on promotion of care in HIV and other sexual transmitted diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Text message via Short Message Service (SMS) is a potential intervention for improving follow up and compliance with recommended care, providing medication and appointment reminders and which can improve compliance and retain patients in care (7,8,(11)(12)(13)(14)(15)(16)(17). Studies on feasibility and e cacy of using text message via SMS in promoting care have been done in many countries; almost all have shown an improvement in health care behaviors and disease outcome (7,8,(11)(12)(13)(14)(15)(16)(17). Nevertheless, there are few studies on the feasibility and effectiveness of using SMS as a means to promote care sub-Saharan Africa and none in Tanzania (7,8,15).…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Efficacy of Text-Messaging to Promote Care Among Trauma Patients Screened for HIV at an Urban Tertiary Emergency Department in Tanzania

Hyuha¹,

Sawe²,

Kilindimo³

et al. 2021

Preprint

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BackgroundDue the high prevalence of Human Immune Virus (HIV), provider-initiated HIV testing for patients attending any health care setting is recommended. However, follow-up and linkage to care by those tested remains poor. We determined the feasibility and efficacy of text-messaging to promote follow-up among otherwise healthy trauma patients who underwent provider-initiated HIV testing and counseling at an Emergency Department (ED) in Tanzania. Material and methodsThis randomized controlled trial was conducted at Muhimbili National Hospital (MNH) ED between September 2019 to February 2020. Adult trauma patients consenting to HIV testing and follow-up text messaging were randomized to standard care (pre and post-test counseling) or standard care plus a series of 3 text-message reminders for follow-up in an HIV clinic, if positive, or retesting, if negative. Investigators blinded to study assignment called participants 2-months after the ED visit if HIV positive, or 4 months if HIV negative. We compared the proportion of people in the intervention and control groups completing recommended follow- up. Secondary outcomes were proportion accepting testing, agreeing to receive SMS and follow-up compliance by HIV status. ResultsOf 290 patients approached, 255 (87.9%) opted-in for testing and consented to the study. The median age of the study population was 29 [IQR 24-40] years. 127 (49.8%) were randomized to the intervention group and 128 (50.2%) to the control group. The short message service (SMS) system verified that 381 text messages in total were received. We traced 242 (94.9%) participants: 124 (51.2%) from intervention group and 118 (48.8%) controls. 100 (39.2%) subjects reported attending a follow-up visit, of which 77 (60.6%) were from the intervention group and 23 (17.9%) were controls. (RR = 3.4, 95%CI (2.3-5.0) resulting in number needed to treat (NNT) of 2.3. Of 246 HIV negative participants, 37% went for repeat-screening: 59% of those in the intervention group and 16% in the control group (RR= 3.7, P =<0.0001, NNT 2.3). Among 9 positive patients, all 5 in the intervention group and 3 of 4 controls had follow-up visits. ConclusionAutomated text message is a feasible and effective way to increase follow up in HIV tested individuals in a limited income country.

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“…Relatively few adults meet the annual testing recommendation and health programs face challenges in encouraging people to retest [ 8 , 9 ]. Furthermore, there are few evidence-based interventions designed specifically to promote frequent retesting for HIV [ 10 ]. Low retesting uptake may be due, in part, to perceptions that retesting is unnecessary if a person continues to feel healthy and recently tested HIV negative [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Financial incentives and deposit contracts to promote HIV retesting in Uganda: A randomized trial

et al. 2021

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Background Frequent retesting for HIV among persons at increased risk of HIV infection is critical to early HIV diagnosis of persons and delivery of combination HIV prevention services. There are few evidence-based interventions for promoting frequent retesting for HIV. We sought to determine the effectiveness of financial incentives and deposit contracts in promoting quarterly HIV retesting among adults at increased risk of HIV. Methods and findings In peri-urban Ugandan communities from October to December 2018, we randomized HIV–negative adults with self-reported risk to 1 of 3 strategies to promote HIV retesting: (1) no incentive; (2) cash incentives (US$7) for retesting at 3 and 6 months (total US$14); or (3) deposit contracts: participants could voluntarily deposit US$6 at baseline and at 3 months that would be returned with interest (total US$7) upon retesting at 3 and 6 months (total US$14) or lost if participants failed to retest. The primary outcome was retesting for HIV at both 3 and 6 months. Of 1,482 persons screened for study eligibility following community-based recruitment, 524 participants were randomized to either no incentive (N = 180), incentives (N = 172), or deposit contracts (N = 172): median age was 25 years (IQR: 22 to 30), 44% were women, and median weekly income was US$13.60 (IQR: US$8.16 to US$21.76). Among participants randomized to deposit contracts, 24/172 (14%) made a baseline deposit, and 2/172 (1%) made a 3-month deposit. In intent-to-treat analyses, HIV retesting at both 3 and 6 months was significantly higher in the incentive arm (89/172 [52%]) than either the control arm (33/180 [18%], odds ratio (OR) 4.8, 95% CI: 3.0 to 7.7, p < 0.001) or the deposit contract arm (28/172 [16%], OR 5.5, 95% CI: 3.3 to 9.1, p < 0.001). Among those in the deposit contract arm who made a baseline deposit, 20/24 (83%) retested at 3 months; 11/24 (46%) retested at both 3 and 6 months. Among 282 participants who retested for HIV during the trial, three (1%; 95%CI: 0.2 to 3%) seroconverted: one in the incentive group and two in the control group. Study limitations include measurement of retesting at the clinic where baseline enrollment occurred, only offering clinic-based (rather than community-based) HIV retesting and lack of measurement of retesting after completion of the trial to evaluate sustained retesting behavior. Conclusions Offering financial incentives to high-risk adults in Uganda resulted in significantly higher HIV retesting. Deposit contracts had low uptake and overall did not increase retesting. As part of efforts to increase early diagnosis of HIV among high-risk populations, strategic use of incentives to promote retesting should receive greater consideration by HIV programs. Trial registration clinicaltrials.gov: NCT02890459.

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A Systematic Review of Interventions that Promote Frequent HIV Testing

Cited by 27 publications

References 51 publications

Appointment reminders to increase uptake of HIV retesting by at‐risk individuals: a randomized controlled study in Thailand

Appointment reminders to increase uptake of HIV retesting by at‐risk individuals: a randomized controlled study in Thailand

Feasibility and Efficacy of Text-Messaging to Promote Care Among Trauma Patients Screened for HIV at an Urban Tertiary Emergency Department in Tanzania

Financial incentives and deposit contracts to promote HIV retesting in Uganda: A randomized trial

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