The Impact of Cell Phone Reminders on Uptake of Medical Male Circumcision in Rakai, Uganda

Abstract

Background: Medical male circumcision (MMC) is a recommended strategy for HIV prevention, but attendance for scheduled MMC is often suboptimal. We assessed the impact of cell phone and in-person reminders on uptake of MMC. Methods:Between October 2010 and June 2011, men participating in the Rakai Community Cohort Study (RCCS) were educated about the risks and benefits of MMC and those who wished to receive free MMC were referred to the Rakai MMC program. Cell phone reminders (calls and/or short message service (SMS)) and in-person renotification or persons without phone contacts were used to remind clients two days before the surgical appointment date. Proportions of men coming for scheduled surgery before (control period) and after the reminders were computed and logistic regression used to estimate adjusted odds ratios (AdjOR) and 95% confidence intervals of attendance for scheduled MMC.Results: Approximately 66.7% of men had cell phone contacts. Overall, the intervention increased attendance for scheduled MMC from 20.5% to 32.4%, AdjOR 2.01 (95%CI, 1.42, 2.83), p<0.001. Among men with no phone contacts, uptake increased from 22.2% to 31.9%, adjusted AdjOR 1.71 (95% CI, 0.97, 3.01) p=0.064, compared to an increase from 19.4% (40/206) to 32.6% (92/282), AdjOR 2.15 (95%CI, 1.39, 3.32) p=0.001 among men who had cell phone contact. Conclusion:Cell phone and in-person reminders of surgery appointments increased MMC uptake, but cell phone reminders are cheaper than in-person re-notification.

Effectiveness of an intervention to increase uptake of voluntary medical male circumcision among men with sexually transmitted infections in Malawi: a preinterventional and postinterventional study

“…Cell phone reminders (SMS and calls) used alone or in combination with other strategies have yielded mixed results in increasing VMMC uptake 38–42. In Kenya, cell phone reminders resulted in a modest improvement in attendance of a postcircumcision clinic at day 7 in older men 40.…”

“… 38–42 In Kenya, cell phone reminders resulted in a modest improvement in attendance of a postcircumcision clinic at day 7 in older men. 40 In Uganda, cell phone reminders significantly increased uptake of circumcision among men in the Rakai community cohort 38 while they did not significantly increase uptake in Zambia. 39 …”

“…36 Cell phone reminders (SMS and calls) used alone or in combination with other strategies have yielded mixed results in increasing VMMC uptake. [38][39][40][41][42] In Kenya, cell phone reminders resulted in a modest improvement in attendance of a postcircumcision clinic at day 7 in older men. 40 In Uganda, cell phone reminders significantly increased uptake of circumcision among men in the Rakai community cohort 38 while they did not significantly increase uptake in Zambia.…”

“…[38][39][40][41][42] In Kenya, cell phone reminders resulted in a modest improvement in attendance of a postcircumcision clinic at day 7 in older men. 40 In Uganda, cell phone reminders significantly increased uptake of circumcision among men in the Rakai community cohort 38 while they did not significantly increase uptake in Zambia. 39 Initially, since the VMMC clinic was no longer colocated at Bwaila hospital, reminders were selected to remind men who could not receive same-day VMMC to go to their nearest clinic for VMMC.…”