Lessons Learned From the Implementation of Seek, Test, Treat, Retain Interventions Using Mobile Phones and Text Messaging to Improve Engagement in HIV Care for Vulnerable Populations in the United States

AIDS Behav. 2017 Nov;21(11):3182-3193. doi: 10.1007/s10461-017-1804-8.


In the United States, little is known about interventions that rely on mobile phones and/or text messaging to improve engagement in HIV care for vulnerable populations. Domestic studies using these technologies as part of the National Institute on Drug Abuse "Seek, Test, Treat, Retain" research initiative were queried regarding intervention components, implementation issues, participant characteristics, and descriptive statistics of mobile phone service delivery. Across five studies with 1,135 predominantly male, minority participants, implementation challenges occurred in three categories: (1) service interruptions; (2) billing/overage issues, and; (3) the participant user experience. Response rules for automated text messages frequently frustrated participants. The inability to reload minutes/texting capacity remotely was a significant barrier to intervention delivery. No study encountered confidentiality breaches. Service interruption was common, even if studies provided mobile phones and plans. Future studies should attend to the type of mobile phone and service, the participant user experience, and human subjects concerns.

Keywords: Engagement in HIV care; Retention in HIV care; SMS; Text messaging; mHealth.

MeSH terms

  • Adult
  • Aged
  • Anti-HIV Agents / therapeutic use
  • Cell Phone*
  • Continuity of Patient Care*
  • Female
  • HIV Infections / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Program Evaluation*
  • Reminder Systems
  • Telemedicine
  • Text Messaging*
  • United States
  • Vulnerable Populations* / psychology
  • Vulnerable Populations* / statistics & numerical data


  • Anti-HIV Agents