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  1. Kennedy M Ngowi1,
  2. Eusibious Maro2,
  3. Pythia T Nieuwkerk3,
  4. Rob E Aarnoutse4,
  5. Blandina T Mmbaga1,2,
  6. I Marion Sumari-De Boer1,5
  1. 1Kilimanjaro Clinical Research Institute, Moshi, Tanzania
  2. 2Kilimanjaro Christian Medical Center, Moshi, Tanzania
  3. 3Department of Medical Psychology, Academic Medical Center, Amsterdam, the Netherlands
  4. 4Department of Pharmacy and with the Radboud Institute for Health Sciences, Radboud UMC, Nijmegen, the Netherlands
  5. 5Department of International Health, Radboud UMC, Nijmegen, the Netherlands


Background Pregnant women living with HIV have difficulties in reaching adequate levels of treatment adherence. One way to intervene is sending reminder cues using short message service (SMS) texts. We conducted a pilot study on the use of SMS among pregnant and breastfeeding women living with HIV in Kilimanjaro, Tanzania. One objective was to investigate user experiences of SMS reminders.

Methods We enrolled adult (age 18–45) pregnant or breastfeeding women living with HIV from Kilimanjaro region, Tanzania. Women received a reminder SMS 30 min before usual time of intake. One hour after usual time of intake, they received an SMS asking whether medication was taken. SMSes were sent less-than-daily and randomly distributed over the week. During consultation we listened to their feedback on the system. After six-months, we interviewed women using a semi-structured exit interview.

Results Twenty-five women were enrolled. Two women were lost to follow-up. We received feedback from 18 women. Sixteen (89%) said they were content about the SMS reminding. One said she had problems with privacy issues (6%), but 5 specifically mentioned no privacy issues (28%). Preliminary results of 18 exit interviews show that 16 women (89%) had a good experience with the SMS. Fourteen women (78%) found the content of SMS good; 2 women (11%) said it was not good at all due to risk of unwanted disclosure. Three women (17%) experienced stigma. Eleven women (61%) told they were always able to reply to the SMS and 16 (89%) believed it really improves adherence.

Conclusion We believe most women were satisfied with the SMS system. A few women had trouble with risks or fear of unwanted disclosure. One way to solve that, may be to send more neutral language messages. The results can be used for clinical trial design to investigate the effect on adherence.

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