For patients with HIV, text message reminders may improve their adherence to appointments at outpatient clinics, according to a study published in AIDS Care.

The researchers conducted a cross-section, case-control study that included 447 patients with HIV who attended an outpatient clinic between March and July 2014. Patients who missed appointments from January 2013 onward were included as cases (n=224). Cases were matched to randomly selected, same-day controls who did not have missed appointments during the same time period (n=223). The researchers collected clinical and socio-demographic data through clinical records and interview-administered questionnaires. The questionnaires also included questions on reasons and possible solutions for nonattendance.

Five risk factors were independently associated with nonattendance:

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  1. Age <30 years (odds ratio 7.2)
  2. African region of origin (odds ratio 2.8)
  3. Having children <12 years of age (odds ratio 2.1)
  4. History of drug or alcohol abuse (odds ratio 4.4)
  5. No combination antiretroviral therapy (odds ratio 2.5) or HIV-RNA >400 copies/ml while receiving combination antiretroviral therapy (odds ratio 3.5)

The most common reason that participants gave for missing an appointment was failure to remember the appointment (44%). The majority of patients (80% of the cases and 55% of the controls) reported that they would prefer to receive an appointment reminder via text message.

Missed clinical visits have been independently associated with all-cause mortality in patients with HIV. The risk factors and strategies identified in this study may represent opportunities for increasing adherence to clinical appointments.


  1. Van Andel E, Been SK, Rokz C, et al. Risk factors in an HIV-infected population for refraining from specialist care. AIDS Care. 2016; Apr 7:1-6. doi: 10.1080/09540121.2016.1168914