Data and Do-files: `Fresh Start' text messaging RCT

<b>Objective</b>: Treatment interruptions are a barrier to successful antiretroviral therapy (ART). “Fresh start messages,” which leverage significant days on the calendar (e.g., new year, public holiday) in order to prompt action, have the potential to encourage people living with HIV to return to care. We evaluated a “fresh start” intervention (text messages) to increase return to care in PLHIV who had missed their last appointment.<b>Design:</b> A three arm 1:1:1 individual randomised controlled trial.<b>Methods:</b><i> </i>We randomized adults in Capricorn District who had missed ART appointments by more than 28 days to: a) no text message; b) <i>unframed</i> messages (fresh start not mentioned); or c) <i>framed</i> messages (fresh start mentioned). Randomisation was stratified by treatment interruption duration and across two holidays (Youth Day, Mandela Day). The primary outcome was an ART-related clinic visit at ≤45 days of the first message.<b>Results:</b><b> 9143</b> participants were randomised. For Youth Day, 1474 and 1468 were sent <i>unframed</i> and <i>framed</i> messages respectively, with 13.4% sent these messages having an ART visit vs 11.9% not sent a message (aOR 1.2; 95% CI:1.0-1.4). For Mandela Day, 1336 and 1334 were sent <i>unframed</i> and <i>framed</i> messages respectively, with 6.7% sent these messages having an ART-related clinic visit vs 5.4% not sent a message (aOR 1.2; 95% CI: 1.0-1.6).<b>Conclusions: </b>Low-cost<b> </b>text messages sent around a “fresh start” date increased the likelihood that patients who missed appointments returned to care. This study demonstrates the potential of text messaging for motivating return to care.<br>