Acceptability and factors associated with willingness to receive short messages for improving antiretroviral therapy adherence in China.

This study aimed to understand the acceptability of short message service (SMS) as a reminder for improving antiretroviral therapy (ART) adherence and determine the factors associated with willingness to accept SMS among people living HIV (PLH) in China. A total of 801 adult patients were recruited in a cross-sectional survey. Factors associated with willingness in unadjusted analyses (α = 0.10) were included in a logistic regression model; 88.4% of the participants owned mobile phones, 49.6% read every short message and 16.2% read only if the phone number was familiar, 79.5% reported daily SMS to remind taking medicine would be helpful, and 68.9% were willing to receive them. In the final model, willingness to accept was positively associated with being young (odds ratio [OR] = 0.32; 95% confidence interval [CI]: 0.11-0.99; p = 0.048), living in the middle or north region (OR = 2.36; 95% CI: 1.24-4.50; p = 0.009, OR = 71.79; 95% CI: 21.53-239.37; p < 0.001, respectively), having primary or "junior or higher" education (OR = 5.80; 95% CI: 2.13-15.86; p = 0.001, OR = 3.20; 95% CI: 1.20-8.58; p = 0.021, respectively), having serious disease condition of stage (OR = 10.01; 95% CI: 2.12-47.30; p = 0.004), being a rural resident (OR = 2.96; 95% CI: 1.72-5.10; p < 0.001), having side effect (OR = 4.74; 95% CI: 1.24-18.03; p = 0.023), and taking a dose two or more hours late in the last 30 days (OR = 2.45; 95% CI: 1.26-4.78; p = 0.009). SMS as a reminder for improving ART adherence is acceptable. The survey results indicate that to be effective, messages need to be more acceptable to elderly patients, urban residents, individuals with earlier stage of HIV disease, and individuals not experiencing side effects. Nonetheless, these results suggest that for a high proportion of PLH in China, reminder messages through mobile phones would be useful for increasing compliance with HIV regimens.