Text message reminders of upcoming clinic appointments and help with handling stigma proved to be the most effective clinic measures for retaining patients in care, a U.S. study published in Clinical Infectious Diseases found.
The retrospective cohort study followed 21,046 PLWH at seven clinic sites for a total of 103,348 person-years. Overall, 67% of participants were retained in care, compared to a U.S. average of 49%. Study sites were “centers of excellence,” which may have better resources than a general HIV clinic and may therefore be better equipped to keep people in care, study authors explained.
Text messages appeared to have the greatest impact, potentially increasing retention by 21% within clinics that did not currently offer them, the researchers determined. (However, only two study sites actually sent such texts at the time of the study.) Stigma support services, which were offered at four study sites, would increase retention in care by 9% in sites where such services were not currently offered, the authors calculated. Email reminders, on the other hand, lowered retention—possibly because texting access is more widespread than email access.
These services covered a wide range of practices, and providing additional clinic-patient contact points may have contributed to the result, study authors noted. They nonetheless recommended that HIV clinics implement text reminders and stigma support to improve retention.