journal.pone.0043832.pdf (230.94 kB)
Download fileText Messaging to Improve Attendance at Post- Operative Clinic Visits after Adult Male Circumcision for HIV Prevention: A Randomized Controlled Trial
journal contribution
posted on 2013-12-03, 00:00 authored by Thomas A. Odeny, Robert C. Bailey, Elizabeth A. Bukusi, Jane M. Simoni, Kenneth A. Tapia, Krista Yuhas, King K. Holmes, R. Scott McClellandBackground: Following male circumcision for HIV prevention, a high proportion of men fail to return for their scheduled
seven-day post-operative visit. We evaluated the effect of short message service (SMS) text messages on attendance at this
important visit.
Methodology: We enrolled 1200 participants .18 years old in a two-arm, parallel, randomized controlled trial at 12 sites in
Nyanza province, Kenya. Participants received daily SMS text messages for seven days (n = 600) or usual care (n = 600). The
primary outcome was attendance at the scheduled seven-day post-operative visit. The primary analysis was by intention-totreat.
Principal Findings: Of participants receiving SMS, 387/592 (65.4%) returned, compared to 356/596 (59.7%) in the control
group (relative risk [RR] = 1.09, 95% confidence interval [CI] 1.00–1.20; p = 0.04). Men who paid more than US$1.25 to travel
to clinic were at higher risk for failure to return compared to those who spent #US$1.25 (adjusted relative risk [aRR] 1.35,
95% CI 1.15–1.58; p,0.001). Men with secondary or higher education had a lower risk of failure to return compared to those
with primary or less education (aRR 0.87, 95% CI 0.74–1.01; p = 0.07).
Conclusions: Text messaging resulted in a modest improvement in attendance at the 7-day post-operative clinic visit
following adult male circumcision. Factors associated with failure to return were mainly structural, and included
transportation costs and low educational level.