Participation in a clinical trial of a text messaging intervention is associated with increased infant HIV testing: A parallel-cohort randomized controlled trial

Thomas A. Odeny, Elizabeth A. Bukusi, Elvin H. Geng, James P. Hughes, King K. Holmes, R. Scott McClelland

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Objective Text messages significantly improve uptake of infant HIV testing in clinical trial contexts. Women who were excluded from a randomized trial in Kenya were followed to create a comparison between women who were enrolled and did not receive the study SMS intervention and women who were screened but not enrolled. Design Parallel-cohort randomized controlled trial analysis. Methods We compared time to infant HIV testing between women in three groups: the Trial SMS group, the Trial Control group, and the Comparison Cohort comprised of women who were screened but not enrolled. Results Of the 1,115 women screened, 388 (35%) were eligible for trial enrollment, and were randomized to receive either intervention text messages (Trial SMS; N = 195) or continue usual care (Trial Control; N = 193). Among 727 women not enrolled in the study (Comparison Cohort), we obtained infant HIV testing data from clinic records for 510 (70%). The cumulative probability of infant HIV testing was highest in the Trial SMS group (92.0%; 95% CI 87.5–95.3), followed by the Trial Control group (85.1%; 95% CI 79.5–89.8), and lowest among women in the Comparison Cohort (43.4%; 95% CI 39.2–47.8). Conclusions Both the Trial SMS group and the Trial Control group were significantly more likely to have their infants tested for HIV compared to the Comparison Cohort, providing evidence of a “clinical trial effect.” This analysis suggests that SMS interventions should be implemented as an adjunct to consistent and engaged delivery of basic health services.

Original languageEnglish
Article numbere0209854
JournalPloS one
Volume13
Issue number12
DOIs
StatePublished - Dec 2018

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