title: Effect of Text Message, Phone Call, and In-Person Appointment Reminders on Uptake of Repeat HIV Testing among Outpatients Screened for Acute HIV Infection in Kenya: A Randomized Controlled Trial.
abstract: BACKGROUND
  Following HIV-1 acquisition, many individuals develop an acute retroviral syndrome and a majority seek care. Available antibody testing cannot detect an acute HIV infection, but repeat testing after 2-4 weeks may detect seroconversion. We assessed the effect of appointment reminders on attendance for repeat HIV testing.
  
  
  METHODS
  We enrolled, in a randomized controlled trial, 18-29 year old patients evaluated for acute HIV infection at five sites in Coastal Kenya (ClinicalTrials.gov NCT01876199). Participants were allocated 1:1 to either standard appointment (a dated appointment card) or enhanced appointment (a dated appointment card plus SMS and phone call reminders, or in-person reminders for participants without a phone). The primary outcome was visit attendance, i.e., the proportion of participants attending the repeat test visit. Factors associated with attendance were examined by bivariable and multivariable logistic regression.
  
  
  RESULTS
  Between April and July 2013, 410 participants were randomized. Attendance was 41% (85/207) for the standard group and 59% (117/199) for the enhanced group, for a relative risk of 1.4 [95% Confidence Interval, CI, 1.2-1.7].Higher attendance was independently associated with older age, study site, and report of transactional sex in past month. Lower attendance was associated with reporting multiple partners in the past two months.
  
  
  CONCLUSIONS
  Appointment reminders through SMS, phone calls and in-person reminders increased the uptake of repeat HIV test by forty percent. This low-cost intervention could facilitate detection of acute HIV infections and uptake of recommended repeat testing.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01876199.
authors.affiliation: Centre for Geographic Medicine Research - Coast (CGMR-C), Kenya Medical Research Institute, Kilifi, Kenya.
authors.forename: Peter M
authors.identifier: http://orcid.org/0000-0002-1808-3292
authors.initials: PM
authors.lastname: Mugo
authors.affiliation: Centre for Geographic Medicine Research - Coast (CGMR-C), Kenya Medical Research Institute, Kilifi, Kenya.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Wahome
authors.affiliation: Centre for Geographic Medicine Research - Coast (CGMR-C), Kenya Medical Research Institute, Kilifi, Kenya.
authors.forename: Evanson N
authors.initials: EN
authors.lastname: Gichuru
authors.affiliation: Centre for Geographic Medicine Research - Coast (CGMR-C), Kenya Medical Research Institute, Kilifi, Kenya.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Mwashigadi
authors.affiliation: Centre for Geographic Medicine Research - Coast (CGMR-C), Kenya Medical Research Institute, Kilifi, Kenya.
authors.forename: Alexander N
authors.initials: AN
authors.lastname: Thiong'o
authors.affiliation: Centre for Geographic Medicine Research - Coast (CGMR-C), Kenya Medical Research Institute, Kilifi, Kenya.
authors.forename: Henrieke A B
authors.initials: HA
authors.lastname: Prins
authors.affiliation: Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.|Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, the Netherlands.
authors.forename: Tobias F
authors.initials: TF
authors.lastname: Rinke de Wit
authors.affiliation: Centre for Geographic Medicine Research - Coast (CGMR-C), Kenya Medical Research Institute, Kilifi, Kenya.|Departments of Medicine, Global Health, and Epidemiology, University of Washington, Seattle, United States of America.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Graham
authors.affiliation: Centre for Geographic Medicine Research - Coast (CGMR-C), Kenya Medical Research Institute, Kilifi, Kenya.|Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.|Nuffield Department of Medicine, University of Oxford, Headington, United Kingdom.
authors.forename: Eduard J
authors.initials: EJ
authors.lastname: Sanders
mesh_terms: D000293:Adolescent; D000328:Adult; D001071:Appointments and Schedules; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D007630:Kenya; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D010045:Outpatients / Q000706:statistics & numerical data*; D017010:Reminder Systems / Q000706:statistics & numerical data*; D013689:Telephone / Q000706:statistics & numerical data*; D060145:Text Messaging / Q000706:statistics & numerical data*; D055815:Young Adult