Text Messaging Joins Africa's War on AIDS

A new study led by Richard Lester of the British Columbia Center for Disease Control in Vancouver finds that using text messages to remind HIV patients to take their medicines can boost adherence.

Under the "WelTel Kenya1" study, Lester and colleagues recruited 538 HIV patients receiving antiretroviral treatment in Kenya. Participants received either a weekly SMS (short-message service) text on their mobile phone or standard care. The text recipients typically received messages like "Mambo?", which is Kiswahili for "How are you?" They were instructed to respond within 48 hours, replying either "Sawa" ("fine") or "Shida" ("problem"). Those who did not respond within the timeframe or who said they had a problem were then contacted by a nurse.

Compared to the control group, the number of patients in the SMS group who achieved 100 percent adherence was 12 percent higher. The SMS group also was 9 percent more likely to achieve HIV viral suppression below detectable levels compared to the control group.

Just 3.3 percent of the texts required a follow-up. That meant one nurse could potentially manage 1,000 patients by SMS and expect to make follow-up calls to just 33 patients per week.

SMS systems are cost-effective since no additional equipment is required. Each text costs around five US cents, and the messages were sent out in computerized batches, rather than individually.

Lester and colleagues suggested the approach could work well in low-income countries hard-hit by AIDS where cell phone use is common.

The study, "Effects of a Mobile Phone Short Message Service on Antiretroviral Treatment Adherence in Kenya (WelTel Kenya1): Randomized Trial," was published early online in The Lancet (doi:10.1016/S0140-6736(10)61997-6).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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