Photo: Manoocher Deghati/IRIN

Signs promoting HIV/AIDS awareness in at a school in Zambia.

Nairobi — Mobile phone communication between clinicians and HIV patients can improve adherence to drug treatment and help to cut viral load, a study has shown.

In the study conducted in Kenya, researchers found that text messages supported improved adherence to antiretroviral therapy (ART) and suppression of the most common strain of HIV.

The WelTel trial involved sending weekly messages to patients asking whether they were well or whether they were experiencing problems with their treatment.

Sarah Karanja, an HIV/sexually transmitted infection prevention officer for the Kenya AIDS Control Project run by the University of Manitoba, Canada, and one of the researchers involved in the study, tells SciDev.Net: "Patient clinician cell phone communication provided constant interaction between the drug providers and the patients. If a patient had a problem, they were able to contact the clinician, who would, in turn, provide immediate assistance."

If a patient failed to call, she says, the clinician would ring to find out why and give assistance. Most of the problems reported during the trial, she says, were related to social stigma or drug side effects.

Adherence trials began in 2005 when antiretroviral drugs were first rolled out in Kenya's hospitals and patients were given fairly widespread access.

At this time, Karanja says, most people already had access to mobile phones, prompting the WelTel Kenya antiretroviral trial based around text messaging to begin in May 2007.

According to Judy Gichoya of the Regional East African Center for Health Informatics, several randomised controlled trials have provided enough scientific evidence about text messaging's role in improving adherence to treatment.

She tells SciDev.Net that the text reminders used in the study, which was published in PLOS One in September, were further proof that they can boost adherence to long-term medication regimes for chronic illness.

"There is a role for cell phone technology in HIV prevention, through promoting adherence to preventive measures," she says. "Patients may use the cell phones for their own personalised initiatives, such as the use of alarms for medication reminders."

But Gichoya warns that the possibility of disclosure of status, loss of privacy and technical difficulties must also be addressed before text messaging can be used on a large scale for health purposes.

"There are no studies describing the use of cell phones to improve adherence to HIV/AIDS treatment guidelines and studies addressing [their use in bringing about] behaviour change [in other health areas] cite difficulty in outcome measurement and high costs as hampering their scalability," she says.

Link to full article