An Adaptive Strategy for Preventing and Treating Lapses of Retention in Adult HIV Care

A randomized controlled trial evaluating the comparative effectiveness of a range of adaptive strategies for retaining patients in Kenya in HIV care and treatment. This study will randomize 2,500 adults initiating antiretroviral treatment (ART) at 4 HIV clinics in Nyanza to (1) standard of care routine education and counselling (REC), (2) SMS text messages, or (3) transport vouchers.

Patients with early signs of weakening retention (defined as the first time a patient is 14 days late for an appointment) will be re-randomized to (1) a single episode of outreach (standard of care), (2) SMS combined with vouchers, or (3) a peer navigator.