Effects of a Short Message Service (SMS) Intervention on Reduction of HIV Risk Behaviours and Improving HIV Testing Rates Among Populations located near Roadside Wellness Clinics: A Cluster Randomised Controlled Trial in South Africa, Zimbabwe and Mozambique
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Short Message Service (SMS) offers an innovative method of promoting sexual health to key and vulnerable populations who are users of mobile phones and are at high risk of HIV infection. This cluster randomised control trial tests the effectiveness of a SMS intervention in reducing HIV risk behaviours and improving HIV testing behaviours among truck drivers, sex workers and community residents located near Roadside Wellness Clinics (RWCs) in three southern African countries. The SMS arm received 35 HIV risk reduction and HIV testing SMSs over a 6-month period. The SMS intervention had no significant impact on sexual risk behaviours. However, participants in the SMS arm were more likely to have tested for HIV in the previous 6 months (86.1% vs. 77.7%; AOR 1.71, 95% CI 1.11–2.66). The results indicate that the general SMS intervention, which provide health promoting information, improved HIV testing rates in key and vulnerable populations in southern Africa.
KeywordsKey populations Sexual risk behaviour Mobile-health HIV testing
We thank our colleagues from University of Gothenburg, Sweden who provided insight and expertise that greatly assisted the research and North Star Alliance Roadside Wellness Clinics for allowing us to undertake research at their sites.
This research was supported by SADC HIV and AIDS Special Fund Round 111. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Study procedures were approved by the University of KwaZulu-Natal Institutional Review Board (BFC483/14) and by national ethical committees (Medical Research Council of Zimbabwe and National Health Bioethics Committee for Mozambique) in each of the three countries.
Informed consent was obtained from all individual participants included in the study.
- 2.The Joint United Nations Programme on HIV/AIDS. UNAIDS Data 2017. 2017. http://www.unaids.org/en/resources/documents/2017/2017_data_book. Accessed 1 Feb 2019.
- 3.The Joint United Nations Programme on HIV/AIDS. The Gap Report 2014: Sex Workers. 2014. http://www.unaids.org/en/resources/documents/2014/Sexworkers. Accessed 1 Feb 2019.
- 10.Kelvin E, George G, Mwai E, Kinyanjui S, Romo M, Odhiambo J, et al. A randomized controlled trial to increase HIV testing demand among female sex workers in kenya through announcing the availability of HIV self-testing via text message. AIDs Behav. 2018;1–10Google Scholar
- 21.Deng L, Geng W, editors. Effects of short message service on HIV prevention among young college students. In: IEEE 8th international conference on information technology in medicine and education (ITME) 2016.Google Scholar
- 25.North Star Alliance. Key figures 2016. http://www.northstar-alliance.org/key-figures/ Accessed 1 Feb 2019.
- 26.Jewkes R, Dunkle K, Nduna M, Shai NJ. Transactional sex and HIV incidence in a cohort of young women in the stepping stones trial. J AIDS Clin Res. 2012;3(5).Google Scholar
- 27.Smith KW, McGraw SA, Costa LA, McKinley JB. A self-efficacy scale for HIV risk behaviors: development and evaluation. AIDS Educ Prev. 1996.Google Scholar
- 30.De Leon E, Fuentes LW, Cohen JE. Characterizing periodic messaging interventions across health behaviors and media: systematic review. J Med Internet Res. 2014;16(3).Google Scholar
- 31.Siedner MJ, Lankowski AJ, Kanyesigye M, Bwana MB, Haberer JE, Bangsberg DR. A combination SMS and transportation reimbursement intervention to improve HIV care following abnormal CD4 test results in rural Uganda: a prospective observational cohort study. BMC Med. 2015;13(1):160.CrossRefGoogle Scholar
- 34.Coates TJ, Kulich M, Celentano DD, Zelaya CE, Chariyalertsak S, Chingono A, et al. Effect of community-based voluntary counselling and testing on HIV incidence and social and behavioural outcomes (NIMH Project Accept; HPTN 043): a cluster-randomised trial. Lancet Global Health. 2014;2(5):e267–77.CrossRefGoogle Scholar
- 35.Young SD, Hlavka Z, Modiba P, Gray G, Van Rooyen H, Richter L, et al. HIV-related stigma, social norms and HIV testing in Soweto and Vulindlela, South Africa: NIMH Project Accept (HPTN 043). J Acquir Immune Defic Syndr. 2010;55(5):620.Google Scholar
- 36.Van Rooyen H, Barnabas RV, Baeten JM, Phakathi Z, Joseph P, Krows M, et al. High HIV testing uptake and linkage to care in a novel program of home_based HIV counseling and testing with facilitated referral in KwaZulu-Natal, South Africa. J Acquir Immune Defic Syndr. 2013;64(1):e1.Google Scholar
- 38.WHO. Consolidated guidelines on HIV prevention, diagnosis, treatment and care for key populations–2016 update: World Health Organization. 2016.Google Scholar