Wise-Pill Intervention

This study is a pilot three-arm randomized controlled trial designed to develop an adherence intervention based on real-time monitoring with the Wisepill pill container, which cellularly transmits a date-and-time stamp every time it is opened. A total of 60 HIV-individuals initiating antiretroviral therapy in southwestern Uganda are being followed for nine months each. In Arm A, participants initially receive short message service (SMS) reminders on a fixed schedule: daily for one month, then weekly for two months. In the remaining six months, they receive an SMS reminder each time they do not open their Wisepill device during a prescribed dosing window. If they do not open the Wisepill device for 48+ hours, SMS notifications are also sent to social supporters. In Arm B, SMS reminders are sent based on Wisepill dosing for the first three months and the SMS notifications to social supporters are added in the remaining six months. In Arm C, no SMS reminders or notifications are sent. Questionnaire data are collected on sociodemographics, including measures of social support and stigma. HIV RNA levels are determined at three and nine months. The primary outcomes compared among the arms will be adherence levels and patterns, as well as virologic suppression. Additionally, qualitative interviews are conducted to understand the mechanisms by which SMS may support adherence.