Texting improves testing: a randomized trial of two-way SMS to increase postpartum prevention of mother-to-child transmission retention and infant HIV testing

Odeny, Thomas A.; Bukusi, Elizabeth A.; Cohen, Craig R.; Yuhas, Krista; Camlin, Carol S.; McClelland, R. Scott

doi:10.1097/qad.0000000000000409

Cited by 151Mobile Health and mHealth ApplicationsHIV/AIDS Research and InterventionsICT in Developing Communities

Texting improves testing: a randomized trial of two-way SMS to increase postpartum prevention of mother-to-child transmission retention and infant HIV testing

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Odeny, Thomas A., Bukusi, Elizabeth A., Cohen, Craig R., Yuhas, Krista, Camlin, Carol S., McClelland, R. Scott·2014·AIDS

DOI 10.1097/qad.0000000000000409PMC PMC4834137

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Abstract

OBJECTIVE: Many sub-Saharan African countries report high postpartum loss to follow-up of mother-baby pairs. We aimed to determine whether interactive text messages improved rates of clinic attendance and early infant HIV testing in the Nyanza region of Kenya. DESIGN: Parallel-group, unblinded, randomized controlled trial. METHODS: HIV-positive pregnant women at least 18 years old and enrolled in the prevention of mother-to-child transmission of HIV programme were randomized to receive either text messages (SMS group, n = 195) or usual care (n = 193). Messages were developed using formative focus group research informed by constructs of the Health Belief Model. The SMS group received up to eight text messages before delivery (depending on gestational age), and six messages postpartum. Primary outcomes included maternal postpartum clinic attendance and virological infant HIV testing by 8 weeks postpartum. The primary analyses were intention-to-treat. RESULTS: Of the 388 enrolled women, 381 (98.2%) had final outcome information. In the SMS group, 38 of 194 (19.6%) women attended a maternal postpartum clinic compared to 22 of 187 (11.8%) in the control group (relative risk 1.66, 95% confidence interval 1.02-2.70). HIV testing within 8 weeks was performed in 172 of 187 (92.0%) infants in the SMS group compared to 154 of 181 (85.1%) in the control group (relative risk 1.08, 95% confidence interval 1.00-1.16). CONCLUSIONS: Text messaging significantly improved maternal postpartum visit attendance, but overall return rates for these visits remained low. In contrast, high rates of early infant HIV testing were achieved in both arms, with significantly higher testing rates in the SMS compared to the control infants.

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In Kenya, some mothers changed attitudes towards attending postnatal clinics for HIV testing of their infants when mHealth communication was used, and their infants were tested.
“In Kenya, some mothers changed attitudes towards attending postnatal clinics for HIV testing of their infants and, as a result, their infants were tested [40].”
From mHealth communication to strengthen postnatal care in rural areas: a systematic review (2019) · cites this paper as [40]
Interactive mobile phone messaging between HCPs and mothers was used to discuss breastfeeding practices and remind mothers to attend PNC clinics.
“Interactive mobile phone messaging between HCPs and mothers was used to discuss breastfeeding practices and remind mothers to attend PNC clinics [40].”
From mHealth communication to strengthen postnatal care in rural areas: a systematic review (2019) · cites this paper as [40]
In Kenya, mothers reported that receiving mHealth communication facilitated PNC services.
“In Kenya, mothers reported that receiving mHealth communication facilitated PNC services [40].”
From mHealth communication to strengthen postnatal care in rural areas: a systematic review (2019) · cites this paper as [40]
Seven randomized controlled trials testing effects of SMS communication on various health outcomes reported positive effects.
“For the seven randomised controlled trials testing effects of SMS communication on various health outcomes had reported positive effects [16, 20, 32, 33, 44–49], while the remaining trial showed no effect of mobile alarm devices on treatment adherence for HIV patients [15].”
From Assessing the feasibility of eHealth and mHealth: a systematic review and analysis of initiatives implemented in Kenya (2017) · cites this paper as [46]

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The Effect of Human Immunodeficiency Virus Prevention and Reproductive Health Text Messages on Human Immunodeficiency Virus Testing Among Young Women in Rural Kenya
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The effect of an interactive weekly text-messaging intervention on retention in prevention of mother-to-child transmission of HIV care: a randomised controlled trial (WelTel PMTCT)
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Authors: Odeny, T. A., Bukusi, E. A., Cohen, C. R., Yuhas, K., Camlin, C. S., & McClelland, R. S.
Affiliations: University of Nairobi (KE)
University of Washington (US)
University of California, San Francisco (US)
Corresponding author: Odeny, Thomas A.
ORCID: Odeny, Thomas A.
Bukusi, Elizabeth A.
Cohen, Craig R.
Yuhas, Krista
Camlin, Carol S.
McClelland, R. Scott
Venue: AIDS
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2014-09-24
Volume: 28
Issue: 15
Pages: 2307-2312
ISSN: 0269-9370 (ISSN-L)
DOI: 10.1097/qad.0000000000000409
PMC: PMC4834137
OpenAlex: W2072428858
Cited by: 151
References: 15
Citations by year: 2026: 1 · 2025: 3 · 2024: 9 · 2023: 7 · 2022: 16 · 2021: 18 · 2020: 13 · 2019: 22 · 2018: 20 · 2017: 20 · 2016: 16 · 2015: 4 · 2014: 1
FWCI: 24.74
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: AIDS (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: Vanderbilt University (R24 TW007988)
University of Washington
National Institutes of Health
Center for AIDS Research, University of Washington (P30 AI027757)
University of California, San Francisco
National Institute on Aging
National Heart, Lung, and Blood Institute
National Institute of Mental Health (K01MH093205)
National Institute on Drug Abuse
National Cancer Institute
National Institute of General Medical Sciences
National Institute of Allergy and Infectious Diseases (P30AI027757)
Fogarty International Center (R24TW007988)
National Institute of Diabetes and Digestive and Kidney Diseases
Office of Women's Health
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords: text messaging, mobile health, prevention of mother-to-child transmission, HIV-positive pregnant women, Health Belief Model, maternal follow-up, sub-Saharan Africa
MeSH terms: Adult, Female, Humans, Infant, Infant, Newborn, Kenya, Male, Pregnancy, Professional-Patient Relations, HIV Infections, Infectious Disease Transmission, Vertical, Postpartum Period, Young Adult, Text Messaging

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Texting improves testing: a randomized trial of two-way SMS to increase postpartum prevention of mother-to-child transmission retention and infant HIV testing

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