Individualized texting for adherence building (iTAB) for methamphetamine users living with HIV: A pilot randomized clinical trial

Drug Alcohol Depend. 2018 Aug 1;189:154-160. doi: 10.1016/j.drugalcdep.2018.05.013. Epub 2018 Jun 21.


Background: Methamphetamine (METH) use poses a barrier to antiretroviral therapy (ART) adherence. We evaluated the efficacy of the individualized texting for adherence building (iTAB) intervention among persons living with HIV (PLWH) who meet criteria for METH use disorder. We examined daily associations between ART adherence and text-reported METH use and depressed mood.

Methods: We conducted a single site, 2-arm, 6-week, pilot randomized clinical trial comparing a personalized, bidirectional, text messaging system (iTAB; n = 50) to an active control condition (n = 25). All participants received adherence psychoeducation and daily texts assessing METH use and depressed mood. The iTAB group received personalized daily ART reminder texts. ART adherence was monitored using Medication Event Monitoring System (MEMS) caps.

Results: Response rates to daily ART reminder texts were high (79%), with good concordance between MEMS-derived and text-reported ART adherence (p < .001). Intervention groups did not differ in MEMS-derived ART adherence (68% iTAB, 70% active control; p = .68); however, participants in the iTAB group had fewer METH use days (median 14.4 iTAB, 22.0 active control; p = .05). Text-reported METH use, but not depressed mood, was associated with poorer MEMS-derived ART adherence.

Conclusions: High text response rates and good concordance between MEMS-derived and text-reported adherence suggests text messaging is a feasible intervention delivery approach that provides a valid indication of ART adherence. Reductions in METH use among iTAB participants suggest daily health reminders may help attenuate substance use. Further research is needed to substantiate daily text messaging as a harm reduction approach.

Keywords: Behavior modification; HIV/AIDS; Medication adherence; Methamphetamine; Stimulant; mHealth.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Amphetamine-Related Disorders / drug therapy*
  • Amphetamine-Related Disorders / epidemiology
  • Amphetamine-Related Disorders / psychology
  • Anti-HIV Agents / therapeutic use*
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / epidemiology
  • HIV Infections / psychology
  • Humans
  • Male
  • Medication Adherence / psychology*
  • Methamphetamine / adverse effects*
  • Middle Aged
  • Pilot Projects
  • Precision Medicine / methods
  • Precision Medicine / trends
  • Reminder Systems / trends
  • Text Messaging / trends*
  • Young Adult


  • Anti-HIV Agents
  • Methamphetamine