Paper Title
Effect of Timing and Frequency of Mobile Phone Text Messaging on Perceived Self-Efficacy for Treatment among People Living with HIV/AIDS in Homa Bay County, Kenya

Background: There were 38 million people living with HIV (PLHIV) by mid-2019 globally. Sub-Saharan Africa is a host to the majority of people living with HIV. In Kenya, about 1.5 Million people are living with HIV. This translates to a prevalence rate of 4.9 percent. Linkage and adherence to treatment is a key indicator of towards the HIV epidemic control as per the Joint United Nations Program on HIV/AIDS 95-95-95 program targets. To achieve these targets, there is need for robust approaches and interventions that can turn around the HIV tide especially in hard hit settings. The text for adherence was implemented in Homa bay county of Kenya as a mobile phone text messaging intervention to improve adherence to treatment among people living with HIV/AIDS. The intervention used various communication strategies. The purpose of this study was to ascertain the effect of timing and frequency of mobile phone text messaging (as two critical communication strategies employed) on perceived self-efficacy for treatment among people living with HIV/AIDS in Homa Bay county, Kenya. Methods: Overall the study used a quasi-experimental design involving a control and an intervention group to assess the effect of the text messaging. Results in this paper are based on participants within the intervention group. The study is based on both quantitative and qualitative data. Simple linear regression models were used to estimate the relationship between the independent variables (timing and frequency of messages) and the dependent variable (self-efficacy). Qualitative data was analyzed thematically and narratives provided under each section in verbatim. Results: The study achieved a sample size of 77.79 per cent of the desired sample (n=543/698). The sample size comprised of 55 per cent control group and 45 per cent intervention group. Timing of the messages was found to have a statistically significant relationship with perceived self-efficacy for appointment adherence (p<0.01; CI=95%)). On the other hand frequency of messages, as a whole, did not have statistically significant relationship with perceived self-efficacy for appointment adherence (p<0.52; CI=95%). However, receiving messages on a monthly basis had a significant relation with perceived self-efficacy p<0.02 ;< 0.05, CI=95%). Conclusion: Correct timing of messages ensures that participants read the messages as required by the intervention. Frequency of messages may depend on factors such as number and type of messages being sent. Recommendations: Mobile text messaging interventions need to consider communication strategies such as timing and frequency of messages. This will ensure that the right numbers of required messages are sent to patients at the right time hence optimum utilization and achievement of the desired outcomes. Keywords - Appointments adherence; Communication strategies; HIV/AIDS; mHealth;Self-efficacy; Text for adherence