Abstract:

Background: Anti-retroviral therapy was introduced in 1997 to manage people living with the Human Immune-deficiency virus (HIV). The success of treatment is dependent optimal levels of 95% or more adherence. A 2015 study conducted at the Rimuka Integrated HIV and TB Centre, revealed a sub-optimal adherence rate 0f 87% by self-report and 65% by pill counts. We set out to investigate the efficacy of cell phone short message service on adherence among clients on ART at the center.

Methodology: KAMPS was a parallel design randomized controlled trial of HIV clients receiving ART at Kadoma (Zimbabwe). Respondents were randomised 1:1. Respondents in the intervention group received a weekly motivational SMS in addition to standard HIV care whilst those in the non-intervention arm received standard care alone. The primary outcome was adherence measured using a composite scale. Secondary outcomes were weight, CD4+; and, viral load, measured at baseline and 26 weeks. The primary analysis was by intention to treat. The trial was registered PACT20161001858240.

Results: Of the 552 assessed respondents, 470 were eligible and were randomized into the study. However, analysis was done for 449 respondents. At 26 weeks, 180 (76.9%) respondents in the intervention group were considered adherent compared to 127(59%) in the non-intervention group (p=0.65). The mean CD4+ cell count at six months was 554 cells mm^-3 among those in the non-intervention group compared to 619 cells per mm^-3 among those in the intervention group. Mean viral load was 392 copies ml^-1 of blood in the intervention group compared to 2859 copies ml^-1 in the non-intervention arm. Among those in the intervention group 140(60%) had viral suppression compared to 93 (43%) in the non-intervention arm.

Conclusion: We conclude that weekly motivational short message influenced adherence and ultimately CD4+ cell count, viral loads and viral suppression.

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