HIV Infections Clinical Trial
Official title:
Text Messaging to Improve Adherence to Post-Operative Clinic Appointments and Reduce Early Resumption of Sexual Intercourse After Adult Male Circumcision: A Randomized Controlled Trial
Male circumcision (MC) reduces, by more than half, the risk of HIV-1 acquisition. WHO and
UNAIDS recommend that "male circumcision should be recognized as an efficacious intervention
for HIV prevention especially in countries and regions with heterosexual HIV epidemics and
low male circumcision prevalence." As a result, programs have been introduced and scaled up
for voluntary medical male circumcision. Kenya leads with the largest expansion of services.
Early resumption of sexual intercourse after MC may have deleterious effects, including
higher rates of post-operative surgical complications, and higher HIV acquisition among
females in couples that resume sexual activity before certified wound healing. In the
context of rapid scale-up of MC, adherence to post-operative clinic appointments allows
clinicians to assess wound healing and to deliver risk reduction counseling. Abstinence from
sexual intercourse before complete wound healing would reduce the rate of post-operative
adverse events and minimize the risk of HIV transmission from HIV-infected men to their
uninfected female partners.
To the investigators knowledge, the effect of reminders delivered via text messaging to
promote adherence to clinic visits and abstinence after MC has not been investigated. The
investigators propose a randomized controlled trial in which men who will have undergone
voluntary medical male circumcision at selected sites in Kisumu will be randomized to
receive either the intervention (context-sensitive text messages after circumcision) or the
control condition (usual care). This study seeks to determine (a) the effect of regular text
messages sent to men after circumcision on attendance of the scheduled 7-day post-operative
clinic visit versus usual care; (b) the proportion of men who resume sexual activity before
42 days post-procedure after receiving regular text messages versus usual care within the 42
days post-circumcision; and (c) to identify potential predictors of failure to attend the
scheduled 7-day post-operative visit and early resumption of sexual intercourse.
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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