The impact of short message service reminders on returning to test for HIV at a community center in Seattle, WA

Objectives: Using data from Gay City, a community testing center in Seattle, we assessed the impact of short message service (SMS) text reminders on returning for a second HIV test. In addition, we investigated whether certain client characteristics were associated with return. Methods: We evaluated data on HIV testing between September 2016 and December 2019. Clients who tested at least once and provided a phone number are included in analyses, and all clients could opt to receive SMS text reminders at three or six months after first test. Poisson regression models were constructed to identify correlates of returning for a second HIV test and to assess the impact of SMS reminders on returning to test. Results: During the period of study, 5,458 clients tested non-anonymously at Gay City. Of these, 1,463 (27.3%) returned for a second HIV test. Participants were less likely to return if they identified as cisgender women (adjusted relative risk [aRR]=0.17; 0.05, 0.53) or gender non-conforming (aRR=0.34; 0.20, 0.56), when compared to cisgender men, or if they identified as bisexual (aRR=0.76; 0.64, 0.90) or straight (aRR=0.38; 0.24, 0.61), when compared to gay clients. At first visit, 1,086 clients opted to receive an SMS reminder (20.8%) for subsequent testing. Of those who received reminders, 30.8% returned for an HIV test in the study period compared to 26.4% of those who did not opt to receive SMS reminders (aRR=1.02; 0.97, 1.09). Conclusion: Few clients returned for a second HIV test during the period of study, and no association between SMS reminders and return was observed. Returning to test was not uniform, with some sexual and gender identities less likely to return in the period of study.