Parkvale Building, Room 305

Robert Gross MD MSCE
Associate Professor of Medicine (ID) and Epidemiology
Co-Director, Penn Center for AIDS Research
University of Pennsylvania Perelman School of Medicine

We did a 1:1 randomized trial of a 2-way cellphone intervention + standard of care (CPI + SOC) adherence support compared with SOC alone, nested in a strategy study of antiretroviral therapy (ART) following second-line ART failure in lower and middle income countries. Text messages were sent over 48 weeks; repeated non-response triggered problem-solving counseling by staff. We enrolled 521 participants at 17 sites in in Africa, Asia and the Americas: week 48 HIV-1 RNA ≤200 copies/mL was reached in 169/257 (66%) CPI+SOC and 164/264 (62%) SOC participants, estimated difference=3.6% (95% CI: −4.6% to 11.9%; p=0.39); virologic failure (VF) occurred in 66 (26%) CPI+SOC and 89 (34%) SOC participants during median 72 weeks follow-up (adjusted p=0.027). Reasons for small intervention effects and future directions will be discussed.