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Table 1 Characteristics of included studies (number of studies = 35)

From: Effectiveness of text messaging interventions on prevention, detection, treatment, and knowledge outcomes for sexually transmitted infections (STIs)/HIV: a systematic review and meta-analysis

First author, year

Interv. period

N

Country

One-way or two-way SMS

Setting

Intervention

Frequency

Comparison

Participants

Follow-up

Outcome results

Reported effect measure from the study

Barnabas 2016 [40]

June 2013–Mar 2015

750

South Africa and Uganda

One-way

Rural clinic

Promotional text sent after HIV testing to encourage circumcision

One text 3 weeks after testing + 1 phone call 1 month after

Standard clinic referral

Men 16–49 years

HIV-negative and uncircumcised

3 months

Uptake of circumcision: proportion being circumcised

RR 1.72 (1.36–2.17)

Bigna 2014 [41]

Jan and May, 2013

121

Cameroon

One-way

Urban (Essos), semi-urban (Kousseri), and rural (Goulfey) hospitals

SMS reminder

2 days prior to appointment

No SMS

Adults ≤ 18 years accompanying an HIV-positive child ≥ 15 years

Unknown

Appointment adherence: proportion attending

OR 2.9 (1.3–6.3)

da Costa 2012 [42]

2008–2009

21

Brazil

One-way

Multidisciplinary Center for Infectious Diseases in Pregnancy, Federal University of São Paulo

SMS reminder 30 min before their last scheduled dose of medicine

Every 2 days

No SMS

HIV-positive Brazilian women

4 months

Medication adherence: MEMS ≤ 95% adherence

NR

Davey 2016 [43]

Nov 2011–Mar 2013

830

Mozambique

One-way

One rural and two urban public health clinic

SMS reminders

2 and 7 days prior to appointment

Standard care

Adults ≤ 18 years receiving first-line ART, for over 15 days

12 months

Appointment adherence: proportion attending

RR 0.68 (0.41–1.13)

de Tolly 2012 [44]

Unknown

2553

South Africa

One-way

General population

3–10 motivational or informative SMS messages

Every 3 days

No SMS

Subscribers of a mobile phone service

3 weeks

Uptake of testing: proportion tested for HIV

OR 1.09 (0.83–1.34)

Downing 2013 [74]

Jan 2010–Mar 2011

94

Australia

One-way

Sexual health clinic

SMS reminder

1 week prior to test of cure

Standard care

Chlamydia + or named as a contact to someone diagnosed with chlamydia

3–4 months

Uptake of testing: proportion who underwent test of cure

OR 5.87 (1.16–29.83)

Dryden-Peterson 2015 [45]

July 2011–April 2012,

366

Botswana

One-way

20 antenatal clinics

Automated platform permitting monitoring and delivery of CD4 results via text

Clinic receipt of results was confirmed centrally via SMS

Standard care

Women with a CD4 count of 250 cells/μL or less were eligible for ART

8 weeks

Uptake of testing: CD4 testing before 26 weeks gestation

ART initiation: before 30 weeks gestation

CD4 testing: aOR 0.87 (0.47–1.63)

ART initiation: aOR 1.06 (0.53–2.13)

Garofalo 2016 [46]

Oct 2010–Feb 2014

105

USA

Two-way

Research facilities

SMS reminder

Daily for 6 months

No SMS

Poorly-adherent HIV-positive adolescents (aged 16–29)

6 months

Medication adherence: self-reported VAS of 90% adherence

Viral load suppression: (< 75 copies/ml)

Adherence: OR 2.12 (1.01–4.45)

Viral load suppression: OR 0.77 (0.24–2.49)

Haberer 2016 [47]

Sept 2013-June 2015

63

Uganda

One-way

Mbarara Regional

Referral Hospital

Reminder scheduled SMS or triggered SMS

Daily for 1 month then weekly for 2 months

No SMS

HIV-positive individuals taking ART

3 months

Medication adherence: MEMS adherence 100%

Viral load suppression: (< 100 copies/ml)

Adherence: IRR 0.6

Viral load suppression: IRR 1.0

Hardy 2011 [48]

Aug 2008–Dec 2008

23

USA

Two-way

Outpatient HIV clinic in Boston

SMS reminders

Daily

One reminder beep at the time of dosing

HIV-positive adults on ART for at least 3 months and reporting less than 85% adherence in past 7 days

6 weeks

Medication Adherence: MEMS at 6 weeks (% not defined)

Adherence (mean difference + [SD]): 33.4 + 9.1

Ignersoll 2015 [49]

May 2012-Aug 2013

63

USA

Two-way

Rural HIV clinic in Virginia

SMS system sent a query, received a response from the participant

Daily: 4 per day

Usual care

HIV-positive adults who reported less than 95% adherence in the past 2 weeks

3 months

Medication adherence: pharmacy refill ≤ 95% adherence

Appointment adherence: proportion of missed visits

NR

Kalichman 2016 [50]

Aug 2011–Mar 2015

600

USA

One-way

Infectious disease clinics in Atlanta

SMS reminders for up to 2 daily medication times

Daily: 2 times per day

No SMS

Adults aged 18 or older, on ART

12 months

Medication adherence: medication refill ≤ 95% adherence

Viral load suppression: (< 100 copies/ml)

Adherence reported as not significant

Viral load suppression: OR 1.24 (1.01–1.52)

Kempe 2016 [51]

Jan 2013–Dec 2013

701

USA

One-way

Pediatric practices in Colorado

Recalling adolescents who were late for HPV doses

Not specified

Standard care

Parents of adolescents aged 11 and 17

Unknown

HPV vaccine series completion: HPV dose 3 completion rates

Vaccine series completion: IRR 1.47 (1.38–1.57)

Lester 2010 [52]

May 2007–Oct 2008

538

Kenya

Two-way

HIV clinic

SMS received from a clinic nurse and response required within 48 h

Weekly

No SMS

Patients initiating ART

12 months

Medication adherence: self-reported ≤ 95% adherence

Viral load suppression: (< 400 copies/ml)

Adherence: RR 0.85 (0.72–0.99)

Viral load did not achieve suppression level: RR 0·84 (0·71–0·99)

Lim 2012 [53]

Jan 2006–Jan 2007

994

Australia and New Zealand

One-way

Music festival

SMS sexual health promotion messages

Every 3–4 weeks

No SMS

Aged between 16 and 29, and were current residents of Victoria or Tasmania and had a mobile phone number

6 and 12 months

Sexual health behaviour change: Always condom use at 6 months, knowledge of STIs at 6 months

Uptake of testing: STI testing at 6 months

Condom use:

F: OR 1.34 (0.58–3.09)

M: OR 0.97 (0.35–2.66)

Knowledge of STIs/HIV:

F: OR 2.36 (1.27–4.37)

M: OR 3.19 (1.52–6.69)

Uptake of testing:

F: OR 2.51 (1.11–5.69)

M: OR 0.79 (0.22–2.89)

Maduka 2013 [54]

2011

104

Nigeria

One-way

Tertiary hospital

Text about adherence and a reminder to take ART

Twice weekly

Standard Care

HIV positive patients known to be non-adherent to HAART

4 months

Medication adherence:

Self-reported ≤ 95 adherence

CD4 cell count increase:

Median CD4+ cell count

Adherence: RR 0.75 (0.55–0.96)

CD4 cell count: intervention increased from 193 cells/ml to 575.0 cells/ml and control from 131.0 cells/ml to 361.5 cells/ml.

Mbuagbaw 2012 [55]

Nov–Dec 2010

200

Cameroon

One-way

Yaounde’ Central Hospital

Weekly motivating text to remind about adherence

Weekly

No SMS

HIV-positive adults on ART, aged 21 years and above

3 months

Medication adherence: Self-reported VAS adherence

Presence of new OI

Adherence: RR 1.06 (0.89–1.29)

Presence of new OI: OR 1.56 (0.85–2.85)

Moore 2015 [56]

Unknown

50

USA

Two-way

University Research Centre

3 SMS daily

Daily

No SMS

HIV-infected methamphetamine users

30 days

Medication adherence: MEMS adherence

NR

Morris 2015 [57]

Sept 2012–Sept 2013

116,878

USA

One-way

San Diego County Immunization Registry records

Parents chose to receive at least one reminder: mail, e-mail, or text reminder

Every 2 weeks until compliant

Email or phone call

Parents/guardians of 11–17 year old males and females

6 months

HPV vaccine series completion: HPV dose 3 completion rates

NR

Mugo 2016 [58]

April and July 2013

410

Kenya

One-way

Health facilities and community pharmacies

SMS and phone-call reminders

One day prior to appointment

Phone call or in-person reminders

18–29 year old patients

Unknown

Uptake of repeat HIV testing: Proportion attending

NR

Norton 2014 * [59]

June–Aug 2010

52

USA

One-way

HIV clinic

SMS reminder

One prior to appointment

Home phone call

HIV-positive adults aged > 17 years

1 month

Appointment adherence: proportion attending

NR

Nsagha 2016 [60]

Aug–Sept 2011

90

Cameroon

One-way

Hospital

Educative text and standard treatment

Weekly: 4 times a week

Standard care

HIV-positive adults aged 23–62 years

1 month

Medication adherence: self-reported ≤ 95% adherence

NR

Odeny 2012 [61]

Sep 2010–Apr 2011

1200

Kenya

One-way

Circumcision clinic

SMS reminders at the post-operative visit

Daily for 7 days before appointment and then 7 daily post-operative

No SMS

Men undergoing circumcision

7 days

Appointment adherence: proportion attending

Appointment adherence: RR 1.09 (0.99–1.19)

Odeny 2014 [62]

Sep 2010–Apr 2011

392

Kenya

Two-way

Maternal postpartum HIV clinic

Text messages

Daily: 8 texts before delivery and 6 texts postpartum

No SMS

HIV-positive pregnant women at least 18 years old

7 days

Appointment adherence: proportion attending

Uptake of testing: virological infant testing by 8 weeks postpartum

Appointment adherence: RR 1.66 (1.02–2.70)

Uptake of testing: 92% SMS vs 85.1% control

RR 1.08 (1.00–1.16)

Orrell 2015 [63]

July 2012–2014

230

South Africa

One-way

HIV clinic

SMS reminders

One if dosing ≥ 30 min late

No SMS

ART-naive participants

48 weeks

Medication adherence: MEMS medication refill ≤ median adherence

Viral load suppression: (≥ 40 copies/mL)

Medication adherence: aOR 1.08 (0.77–1.52)

Viral load suppression: aOR 0.77 (0.42–1.40).

Patel 2014 [64]

Sep 2011–Oct 2012

365

USA

One-way

Planned Parenthood health centers

Text messages

Unknown

Standard care

Females 19–26 who were vaccinated once for HPV

32 weeks

HPV vaccine series completion: HPV dose 3 rates

aOR 0.97 (0.55–1.68)

Perron 2010 [65]

Apr–Jun 2008

2123

Switzerland

One-way

Primary care and HIV clinics

Phone, text, mail

One 2 days prior to appointment

No SMS

Adult patients (mean age 46)

36 weeks

Appointment adherence: proportion attending

NR

Pop-Eleches 2011 [66]

Jun 2007–Jan 2008

431

Kenya

One-way

Chulaimbo Rural Health Center

Four different SMS reminder interventions

Daily or weekly

No SMS

Patients who had initiated ART within 3 months

48 weeks

Medication Adherence: MEMS ≤ 90% adherence

NR

Rand 2015 [67]

July 2013–March 2014

1924

USA

One-way

Large not-for-profit MCO

Parents sent reminders of HPV vaccine dose

Up to 4 text messages sent

Standard care

Parents of publicly insured adolescents aged 11–16 years

8 months

HPV vaccine series completion: HPV dose 3 rates

HR 1.30 (0.7–2.6)

Rand 2017 [68]

Dec 2013–April 2014

391

USA

One-way

3 primary care urban clinics in New York

SMS reminder

3 reminders for each dose (1 week apart)

Sent 1 text with a health message

Parents of 11- to 17-year-olds

Unknown

HPV vaccine completion: HPV dose 3 rates

HR 2.34 (1.67–3.27)

Richman 2016 [69]

Aug 2011 Dec 2013

264

USA

One-way

University campus student health center

5 messages and 2 reminders

Monthly: 7 messages, once per month

Paper card with next appointment date

Uni students ages of 18 and 26 voluntarily initiating the first HPV vaccine dose

7 months

HPV vaccine completion: HPV dose 3 rates

HPV vaccine completion not significantly different

Rutland 2012 [70]

ND

252

UK

One-way

GU medicine

(GUM) clinics

SMS reminder

SMS sent 1 week after missed appointment

No SMS

Non-attending patients aged 16–30 years

6 months

Appointment adherence: proportion re-attending

NR

Sabin 2015 [71]

Dec 2012–Oct 2013

119

China

One-way

Guangxi Center for Disease Control and Prevention ART clinic

Reminders after late dose taking

Unlimited

No SMS

HIV-positive adult patients on HIV treatment

6 months

Medication adherence: MEMS ≤ 95% optimal adherence

Optimal adherence: RR 1.7 [1.3–2.2]

Shet 2014 [72]

July 2010–June 2011

631

South India

Two-way

Hospitals in Bangalore, Mysore, and Chennai

Pictorial reminder 4 days after an automated motivationalcall

Weekly

No SMS

Patients on ART

24 months

Medication adherence: medication refill ≤ 95% adherence

Viral load suppression:

(> 400 copies/mL)

Suboptimal adherence: IRR 1.24 (0.93–1.65)

Viral load did not achieve suppression levels: HR 0.98 (0.67–1.47)

Suffoletto 2013 [73]

Sep 2011–Apr 2012

52

USA

Two-way

Urban emergency department

SMS behavioral questions

Weekly

SMS reminders to complete study questionnaires

Female patients aged 18–25 years with hazardous drinking behavior and recent risky sexual encounters

3 months

Sexual health behaviour change: always condom use in past 28 days; alcohol or drug use in past 28 days (not reported)

Sexual health behaviour change: OR 1.32 (0.31–5.71)

  1. aOR adjusted odds ratio, ART antiretroviral therapy, GUM genitourinary medicine, HPV human papillomavirus, HR hazard ratio, Interve: intervention, IRR incidence rate ratio, MCO managed care organization, MEMS medication event monitoring system, mL milliliter, NR not reported, OI opportunistic infections, OR odds ratio, RR risk ratio, SD standard deviation, SMS short message service, VAS visual analog scale
  2. *Recruited participants. While they were in the clinic, we were already selecting for a group of patients who were more likely to attend their next appointment
  3. **Nonattenders such as at highest risk for nonattendance