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Objectives  The aim of the study was to determine whether behaviourally informed short message service ( SMS ) primer and reminder messages could increase the return rate of  HIV  self‐sampling kits ordered online.    Methods  The study was a 2 × 2 factorial design randomized control trial. A total of 9585 individuals who ordered a self‐sampling kit from  www.freetesting.hiv  different SMS combinations: 1) standard reminders sent days 3 and 7 after dispatch (control); 2) primer sent 1 day after dispatch plus standard reminders; 3) behavioural insights (BI) reminders (no primer); or 4) primer plus BI reminders. The analysis was restricted to individuals who received all messages ( n  = 8999). We used logistic regression to investigate independent effects of the primer and  BI  reminders and their interaction. We explored the impact of sociodemographic characteristics on kit return as a secondary analysis.    Results  Those who received the primer and  BI  reminders had a return rate 4% higher than that of those who received the standard messages. We found strong evidence of a positive effect of the  BI  reminders (odds ratio 1.13; 95% confidence interval 1.04–1.23;  P  = 0.003) but no evidence for an effect of the primer, or for an interaction between the two interventions. Odds of kit return increased with age, with those aged ≥ 65 years being almost 2.5 times more likely to return the kit than those aged 25–34 years. Men who have sex with men were 1.5–4.5 times more likely to return the kit compared with other sexual behaviour and gender identity groups. Non‐African black clients were 25% less likely to return the kit compared with other ethnicities.    Conclusions  Adding  BI  to reminder messages was successful in improving return rates at no additional cost.

hiv medicine

Using behavioural insights to increase  HIV  self‐sampling kit returns: a randomized controlled text message trial to improve England's  HIV  self‐sampling service