Patient Preferences for Message Content in a Mobile Health (mHealth) Human Immunodeficiency Virus (HIV) Testing Campaign

Abstract

Background. There are 50,000 newHIV infections in theU.S. yearly. Racial and ethnic minorities-the populations hardest hit by the epidemic-remain under-tested for HIV. Physicians are not routinely HIV testing, and would prefer that patients ask for the test. Mobile phone text messages are ubiquitous and offer a cost-effective campaign medium to deliver HIV testing information. Text messages can be tailored, targeted, and timed near an appointment. A text message campaign could cue patients to request the HIV test from their physician. This study sought to (1) determine preferredHIV testing textmessage content and (2) assess if the texts could prompt patients to request an HIV test. Methods. Using CDC MessageWorks as a guide, we drafted 11 HIV testing text messages. Message types included awareness, instruction, and positive and negative persuasive content. All messages concluded with “Remind Dr. [Jones] to test you for HIV today.” We interviewed patients to obtain feedback on the messages. We enrolled patients to receive a text message and participate in a post-text evaluation survey. Enrollment is ongoing. Results. Ten patients provided qualitative feedback on the 11 text messages. Participants preferred the text containing an HIV testing recommendation from their health system, and containing information about who should be tested. They also preferred messages which normalized HIV testing. Participants did not prefer texts that contained a fear appeal. The research team selected four final text messages. Twenty-seven participants have been enrolled to receive these texts. Of these, 18 were female (66.7%). Ten participants were Hispanic, nine were Black, seven were White, and one was Asian. Four of the six participants (66.7%) who have been sent a text message reported requesting an HIV test from their physician. During the evaluation, participants preferred short messages that reminded them of a test they needed. Conclusion. With input from the target population, we developed an innovative patient-facing HIV testing text message campaign that normalizes HIV testing and cues them to ask their physician for the HIV test. Over the next three months, this research will demonstrate whether this campaign improves HIV testing in a primary care setting.