Description of Session
The retention of HIV patients on antiretroviral therapy (ART) is critical in achieving the global UNAIDS 95-95-95 targets. Given the critical role of retention in care and adherence to antiretroviral therapy, the USAID Boresha Afya Southern Zone program introduced a mobile-based reminder system that automatically sends text messages for improving adherence three days before and on the day of the appointment. A study involving 1,820 patients from 135 HIV care and treatment centers (CTC) who received text reminders and 5,126 patients from 176 CTSs who didn’t receive text reminders was conducted in Tanzania’s five regions (Iringa, Lindi, Morogoro, Mtwara, Njombe) to understand the role of text reminders in improving retention. Retention-related data was collected for 12 months (April/2018 – March/2019). The mobile numbers of consenting clients on ART in the CTC database were registered on SMS reminder system. To protect confidentiality, the system extracted only patient ID and telephone numbers. Enrolled clients received two types of adherence SMS reminders on their mobile phones: three days in advance and the second on appointment day. The study showed that the average retention among clients receiving text reminders was 92.6% (Iringa 94.3%, Lindi 94.5%, Morogoro 91%, Mtwara 92.8%, Njombe 92%) while average retention among clients who didn’t receive reminders was 56.8% (Iringa 57.4%, Lindi 58.4%, Morogoro 52.8%, Mtwara 52.6%, Njombe 63%). The study showed that scheduled mobile text reminders have demonstrated significant improvement retention. A client who received at least 1 successful SMS reminder was 9 times more likely to be retained compared with those who didn't receive (p< 0.001). Patients changing their phone number over time was a challenge and to overcome this, the initiative required each patient to update their contact information at every visit. Zero-rated USSD is considered in lieu of SMS to reduce transmission costs.
