Trial reportPloS one2015
An augmented SMS intervention to improve access to antenatal CD4 testing and ART initiation in HIV-infected pregnant women: a cluster randomized trial.
Trial report in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 6 syntheses or guidelines pooled it, 44 citations in OpenAlex.
- Acceptability, Needs, Concerns, and Barriers to Digital-Based Interventions for the Prevention of Mother-to-Child Transmission of HIV: Systematic Review and Qualitative Meta-Aggregation.JMIR medical informatics · 2025Pooled it
- Impact of mHealth interventions on maternal, newborn, and child health from conception to 24 months postpartum in low- and middle-income countries: a systematic review.BMC medicine · 2024Pooled it
- Pooled it
- Effectiveness of text messaging interventions on prevention, detection, treatment, and knowledge outcomes for sexually transmitted infections (STIs)/HIV: a systematic review and meta-analysis.Systematic reviews · 2019Pooled it
- A Systematic Review on Promoting Adherence to Antiretroviral Therapy in HIV-infected Patients Using Mobile Phone Technology.Applied clinical informatics · 2018Pooled it
- Systematic review of mobile health behavioural interventions to improve uptake of HIV testing for vulnerable and key populations.Journal of telemedicine and telecare · 2017Pooled it
- A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial.Journal of acquired immune deficiency syndromes (1999) · 2022Trial
- Sizanani: A Randomized Trial of Health System Navigators to Improve Linkage to HIV and TB Care in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2016Trial
- Applications and implementation considerations for stepped-wedge designs in sub-Saharan Africa: a systematic review.Frontiers in epidemiology · 2026Review
- Patient perspective on the elimination mother-to-child transmission of HIV, syphilis, and hepatitis B in Bali, Indonesia: a qualitative study.BMC public health · 2024Article
- The impact of the COVID-19 pandemic on HIV healthcare delivery for females in sub-Saharan Africa: A scoping review.PLOS global public health · 2024Article
- Recommendations for Developing a Telemedicine Strategy for Botswana: A Meta-Synthesis.International journal of environmental research and public health · 2023Article
- Utility of Short Message Service (SMS) for Remote Data Collection for HIV in Low- and Middle-Income Countries.Current HIV/AIDS reports · 2020Review
- Implementation of eHealth Interventions Across the HIV Care Cascade: a Review of Recent Research.Current HIV/AIDS reports · 2018Review
- Text Messages Sent to Household Tuberculosis Contacts in Kampala, Uganda: Process Evaluation.JMIR mHealth and uHealth · 2018Article
- Lack of Virological Suppression Among Young HIV-Positive Adults in Botswana.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Same-day antiretroviral therapy (ART) initiation in pregnancy is not associated with viral suppression or engagement in care: A cohort study.Journal of the International AIDS Society · 2018Article
- Stepped wedge cluster randomized controlled trial designs: a review of reporting quality and design features.Trials · 2017Review
- Stepped wedge cluster randomised trials: a review of the statistical methodology used and available.BMC medical research methodology · 2016Review
- Cell Phone-Based and Adherence Device Technologies for HIV Care and Treatment in Resource-Limited Settings: Recent Advances.Current HIV/AIDS reports · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 8 institutions in 2 countries.
Funding
Abstract
backgroundLess than one-third of HIV-infected pregnant women eligible for combination antiretroviral therapy (ART) globally initiate treatment prior to delivery, with lack of access to timely CD4 results being a principal barrier. We evaluated the effectiveness of an SMS-based intervention to improve access to timely antenatal ART.
methodsWe conducted a stepped-wedge cluster randomized trial of a low-cost programmatic intervention in 20 antenatal clinics in Gaborone, Botswana. From July 2011-April 2012, 2 clinics were randomly selected every 4 weeks to receive an ongoing clinic-based educational intervention to improve CD4 collection and to receive CD4 results via an automated SMS platform with active patient tracing. CD4 testing before 26 weeks gestation and ART initiation before 30 weeks gestation were assessed.
resultsThree-hundred-sixty-six ART-naïve women were included, 189 registering for antenatal care under Intervention and 177 under Usual Care periods. Of CD4-eligible women, 100 (59.2%) women under Intervention and 79 (50.6%) women under Usual Care completed CD4 phlebotomy before 26 weeks gestation, adjusted odds ratio (aOR, adjusted for time that a clinic initiated Intervention) 0.87 (95% confidence interval [CI]0.47-1.63, P = 0.67). The SMS-based platform reduced time to clinic receipt of CD4 test result from median of 16 to 6 days (P<0.001), was appreciated by clinic staff, and was associated with reduced operational cost. However, rates of ART initiation remained low, with 56 (36.4%) women registering under Intervention versus 37 (24.2%) women under Usual Care initiating ART prior to 30 weeks gestation, aOR 1.06 (95%CI 0.53-2.13, P = 0.87).
conclusionsThe augmented SMS-based intervention delivered CD4 results more rapidly and efficiently, and this type of SMS-based results delivery platform may be useful for a variety of tests and settings. However, the intervention did not appear to improve access to timely antenatal CD4 testing or ART initiation, as obstacles other than CD4 impeded ART initiation during pregnancy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.