Behavioral Challenge

How can we help people with HIV and TB overcome hassles and embarrassment to go to the health clinic—and continue going—even when they start to feel better?

Background

People who are co–infected with both HIV and Tuberculosis (TB) face many challenges. First, they are likely to feel very sick, which makes going to the clinic for treatment and medicine difficult.  Being HIV positive still carries a stigma in most communities, and therefore many people are hesitant to go for treatment because they are afraid to be seen by friends or neighbors. Yet, appointment and medicine adherence is critical if they are to get better. Finally, after a few weeks on TB treatment, many people start to feel significantly better—even though they are not yet healthy—and are likely to drop off treatment before the full regimen is complete.

 To address some of these challenges, with USAID funding and design support from the Social and Behavioral Science Team (SBST), ARK and EGPAF designed an SMS reminder program that would send timed appointment reminders and motivational messages to people living with HIV and TB. 

Redesign/Intervention

With support from the SBST, we designed the SMS reminders to have an increased level of personalization. Rather than a simple text reminder (e.g. “don’t forget your appointment”), messages noted where that person was in their treatment cycle and recognized them for making it so far.  

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In addition, specific messages were designed to be sent at the moment that most people drop off treatment. These messages recognized that the person might be feeling better but was not yet fully healthy.  

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Evaluation Design

This is a randomized control trial with some people assigned to the SMS message treatment and others in a control group without SMS messages.

Results

Forthcoming