Improving adherence to antiretroviral therapy in adolescents and young adults living with HIV/AIDS: A pilot study using daily short message service (SMS) reminders

Background: Effective long-term treatment of HIV/AIDS is significantly impacted by adherence to highly active anti-retroviral therapy (HAART). Adherence to a chronic drug regimen like HAART can be difficult for anybody, but is particularly challenging for adolescents and young adults who are infected with HIV. Methods: To evaluate the feasibility, acceptability and effectiveness of a daily short message service (SMS) medication reminder to improve HAART adherence among poorly adherent HIV-positive adolescents and young adults, 25 participants between the ages of 14 and 29 were recruited and administered the intervention over a 24-week period. Adherence was evaluated using the visual analog scale and the AIDS Clinical Trial Group (ACTG) questionnaire. Biomarkers for adherence including viral load and CD4 cell count were obtained at baseline and weeks 12 and 24. Results: The reminder system was feasible and participants found it acceptable, with 21 (84%) of the participants retained for the entire study period and 20 (95%) of those who completed the study finding the intervention helpful to avoid missing doses. Visual analog scale scores and ACTG adherence measures improved significantly at 24 weeks (p < .001 and p < .005, respectively). Biomarkers improved in the expected directions, though not significantly. Conclusion: In this pilot study, daily SMS reminders were a feasible and acceptable intervention and they significantly improved self-reported adherence. Larger controlled studies are needed to evaluate the impact of SMS reminders on HAART adherence in the long term and related health outcomes for youth living with HIV/AIDS.