Implementation of free-draft text messaging to enhance care retention and satisfaction for persons living with HIV infection

ABSTRACT

Eligible persons with HIV infection can receive client-centered case management to coordinate medical and social services. Novel mobile health interventions could improve effective case management and retention in care, an important goal to help end the HIV epidemic. Using a hybrid type I effectiveness-implementation design, we assessed whether access to bidirectional, free-draft secure text messaging with a case manager and clinic pharmacist could improve client satisfaction and care retention in a Southern academic HIV clinic. Sixty-four clients enrolled between November 2019 and March 2020, had a median age of 39 years, and were mostly male, single, and African-American. Heavy app users texted over 100 times (n = 6) over the course of the 12-month intervention while others never texted (n = 12). App usage peaked during months of clinic closure due to COVID-19. Most participants reported high satisfaction with the app and planned continued usage after study completion. Changes in clinic retention and virologic suppression rates were not observed, a result confounded by practice changes due to COVID-19. High usage and satisfaction of free-draft text messaging in case-managed HIV clients supports inclusion of this communication option in routine HIV clinical care.

KEYWORDS:

• Care retention
• case management
• text messaging
• mobile health intervention
• HIV

Acknowledgements

We would like to thank the patients and clinic staff for their participation in this study. This study was funded by ViiV Healthcare.

Disclosure statement

EGM has served on an expert panel for ViiV Healthcare. VF has served on an implementation science advisory panel for ViiV Healthcare. No other authors have conflicts to report.

Data availability statement

Available from the corresponding author upon request.

Additional information

Funding

This study was funded by ViiV Healthcare. This study was also supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of the National Telehealth Center of Excellence Award (U66 RH31458) and the South Carolina Clinical & Translational Research (SCTR) Institute (NIH/NCATS Grant Number UL1TR001450). EGM is also supported by the NIGMS of the National Institutes of Health (P20GM130457).