Text message reminders double HIV re-testing rates in gay men

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Text message reminders significantly increase re-testing rates in gay men for HIV and other sexually transmitted infections (STIs), Australian investigators report in the online edition of Sexually Transmitted Infections

Testing rates were twice as high among men who received the reminders than in men who did not.

“To our knowledge, this is the first published study to demonstrate improved HIV/STI re-testing in MSM [men who have sex with men] through SMS [short message service] reminders,” comment the investigators.


odds ratio (OR)

Comparing one group with another, expresses differences in the odds of something happening. An odds ratio above 1 means something is more likely to happen in the group of interest; an odds ratio below 1 means it is less likely to happen. Similar to ‘relative risk’. 

mathematical models

A range of complex mathematical techniques which aim to simulate a sequence of likely future events, in order to estimate the impact of a health intervention or the spread of an infection.

Gay and other men who have sex with men in Australia are recommended to have an annual HIV test. More frequent tests, at intervals of every three to six months, are recommended for individuals with riskier sex lives. Mathematical modelling has suggested that increasing the proportion of individuals who are aware of their HIV status could help reduce HIV incidence.

However, only a quarter of high-risk gay men have two or more HIV tests and sexual health screens each year.

Investigators from the Sydney Sexual Health Centre wished to see if sending text or SMS reminders to gay men increased testing rates.

To test this, they designed a study involving 714 HIV-negative gay men who had an HIV test and sexual health screen between January and August 2009. Every four months, reminders to re-test were sent to these individuals.

Testing frequency in these individuals was compared to those of two other groups. The first included 1084 men who had an initial HIV test or sexual health screen in the same period, but did not receive text reminders.  The second comparison group included 1753 men who were tested at the clinic in 2008, and therefore before the introduction of the text reminder service.

Results of the study showed that re-testing rates were significantly higher in the group who received text reminders (64%) than the comparison group (30%, p < 0.001), and the pre-text population (31%, p < 0.001).

After taking into account some differences in the study groups, the investigators found that receiving a text reminder was associated with a four-fold increase in the chances of re-testing (odds ratio [OR] = 4.4; 95% CI, 3.5 – 5.5, p < 0.001).

“The HIV/STI re-testing rate was more than double among MSM who received SMS reminders compared to those who did not,” write the investigators, adding “after adjusting for differences in baseline characteristics, HIV/STI re-testing was three to four times more likely in the SMS group than the comparison group.”

The investigators believe that the text reminder service has a number of attractive features: “it allowed large numbers of messages to be sent simultaneously and automatically, reminders were direct, immediate and cheap to send and demanded minimal labour.”

They believe that if adopted more widely, text reminder to attend for repeat HIV tests and sexual health screens, “have great potential to reduce HIV/STI infection rates in the MSM community. More randomised trials at other sexual health clinics and primary care settings are needed.”


Bourne C et al. Short message service reminder intervention doubles sexually transmitted infection/HIV re-testing rates among men who have sex with men. Sex Transm Infect, online edition, DOI: 10.1136/sti.2010.048397, 2011 (click here for the free abstract).