Developing a mobile health (mHealth) HIV testing text message campaign for an ambulatory clinic population

Background: Despite the critical role antiretroviral therapy has had in making HIV a chronic disease, approximately 50,000 new HIV infections occur yearly. Many of these new transmissions occur from individuals who are not aware of their diagnosis. To combat this, HIV testing has been recommended for all adults in healthcare settings. Yet, even with these recommendations, HIV testing is far from routine. Simply put, the conversation about HIV testing is not happening in the ambulatory clinic setting. Physicians are unsure of how to initiate the conversation, and many at-risk patients are unaware of who should be tested for HIV. However, patients want this information, and providers would like patients to request HIV testing for them. A novel approach to this communication disconnect could involve text messaging patients prior to their clinic appointment to cue them to action in regards to HIV testing. Methods: This study enrolled 35-55 year old patients at an ambulatory clinic in Houston, TX who had not been HIV tested according to an Electronic Medical Record review. Messages were developed and pretested with a target patient population, then delivered to enrolled patients before their appointments. Surveys were then conducted over the phone to determine whether any of the messages were successful in changing patient intention and behavior in regards to HIV testing. Results: Thus far, 26 patients have been enrolled in the study and 13 have completed all steps of the study. There are not enough patients to differentiate definitively between message types. However, one text message has been successful in cueing both recipients to ask for and receive an HIV test from their provider. Discussion: This actively enrolling study is seeking to determine whether a timed, tailored, and targeted text message intervention is capable of addressing substandard HIV testing in the ambulatory clinic setting. Early results suggest that this intervention could be successful, although more data are needed to make greater conclusions on message efficacy and the success of specific message types