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BACKGROUND: 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-to-treat. 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 US1. 25 to travel to clinic were at higher risk for failure to return compared to those who spent ≤ US1. 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. TRIAL REGISTRATION: ClinicalTrials. govNCT01186575.
Odeny et al. (Wed,) studied this question.