Journal of AIDS & Clinical Research

The Impact of Cell Phone Reminders on Uptake of Medical Male Circumcision in Rakai, Uganda

Abstract

Kighoma N, Nakigozi G, Watya S, Serwadda D, Nalugoda F, Nkale J, Sewankambo NK, Maria Wawer, Gray RH and Kigozi G

Background: Medical male circumcision (MMC) is a recommended strategy for HIV prevention, but attendance for scheduled MMC is often suboptimal. We assessed the impact of cell phone and in-person reminders on uptake of MMC. Methods: Between October 2010 and June 2011, men participating in the Rakai Community Cohort Study (RCCS) were educated about the risks and benefits of MMC and those who wished to receive free MMC were referred to the Rakai MMC program. Cell phone reminders (calls and/or short message service (SMS)) and in-person renotification or persons without phone contacts were used to remind clients two days before the surgical appointment date. Proportions of men coming for scheduled surgery before (control period) and after the reminders were computed and logistic regression used to estimate adjusted odds ratios (AdjOR) and 95% confidence intervals of attendance for scheduled MMC. Results: Approximately 66.7% of men had cell phone contacts. Overall, the intervention increased attendance for scheduled MMC from 20.5% to 32.4%, AdjOR 2.01 (95%CI, 1.42, 2.83), p<0.001. Among men with no phone contacts, uptake increased from 22.2% to 31.9%, adjusted AdjOR 1.71 (95% CI, 0.97, 3.01) p=0.064, compared to an increase from 19.4% (40/206) to 32.6% (92/282), AdjOR 2.15 (95%CI, 1.39, 3.32) p=0.001 among men who had cell phone contact. Conclusion: Cell phone and in-person reminders of surgery appointments increased MMC uptake, but cell phone reminders are cheaper than in-person re-notification.