| Title: |
The Effect of SMS Reminders on PrEP Adherence in Young Kenyan Women: Findings from a Randomized Controlled Trial |
| Authors: |
Haberer, Jessica E.; Bukusi, Elizabeth A.; Mugo, Nelly R.; Pyra, Maria; Kiptinness, Catherine; Oware, Kevin; Garrison, Lindsey E.; Thomas, Katherine K.; Musinguzi, Nicholas; Morrison, Susan; Anderson, Peter L.; Ngure, Kenneth; Baeten, Jared M. |
| Source: |
Lancet HIV |
| Publication Year: |
2021 |
| Subject Terms: |
Article; hisphilso; demo |
| Description: |
BACKGROUND: Pre-exposure prophylaxis (PrEP) is highly effective for preventing HIV acquisition. However, adherence among young women has been challenging. SMS reminders have been shown to improve adherence to antiretroviral therapy in some contexts, including in combination with real-time adherence monitoring. We therefore assessed the impact of SMS reminders on PrEP adherence among young women in Kenya over 2 years. METHODS: The MPYA (Monitoring PrEP among Young Adult women) study was a randomized controlled trial involving 18–24-year-old women with high risk for HIV (NCT02915367). Participants were recruited from colleges/vocational institutions, informal settlements, and community-based organizations supporting young women. PrEP adherence was measured with a real-time electronic monitor and pharmacy refill. Study staff randomized participants 1:1 to SMS reminders versus no reminders. Reminders were initially sent daily and participants could switch to “as needed” reminders (i.e., sent only if they missed opening the monitor as expected) after 1 month. Study arm assignment was known to study staff but masked to investigators. Study visits occurred at 1 month, 3 months, and then quarterly. Effects of SMS reminders on adherence were assessed as the primary outcome by negative binomial models adjusted for study site and quarter. FINDINGS: We enrolled 348 women between December 21, 2016 and February 5, 2018. The median age was 21 years; two-thirds reported condomless sex in the month before baseline. We assigned 173 participants to receive daily SMS reminders (24 [14%] later opted for “as needed” reminders) and 175 participants to no reminders; 97% (N=69,291/71,791) of SMS reminders were sent as planned. Among participants picking up PrEP (thus potentially indicating desire for HIV protection), electronically monitored adherence averaged 26.8% over 24 months and was similar by arm (27.0% with SMS; 26.6% without SMS; adjusted incidence rate ratio 1.16 ([95% CI 0.93, 1.45; p=0.19]). We also found no significant . |
| Document Type: |
text |
| Language: |
English |
| Relation: |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289198/ |
| Availability: |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289198/ |
| Rights: |
undefined |
| Accession Number: |
edsbas.52C9722D |
| Database: |
BASE |