Pilot program focuses on rural HIV patients

Health care providers with the University of Virginia's Infectious Disease Clinic are piloting a text-messaging program they hope will improve contact with HIV patients living in rural areas.

The program was launched this summer after Mary Rafaly, a U.Va. clinical social worker doing outreach work with HIV patients, found those living in rural areas missed appointments and fell out of treatment more often than patients living in urban areas.

As part of the pilot program, patients are given cell phones that are programmed to limit them to receiving text messages, calling health care providers and calling emergency contacts.

Designed to send text message reminders to patients about medication regimens and pending medical appointments, the program is a takeoff on one Rebecca Dillingham, assistant professor in U.Va.'s department of medicine, worked with in Haiti.

In Haiti, Dillingham said, doctors used cell phones to communicate with HIV patients when clinical appointments were impossible, or dangerous, to keep -- such as in cases of political unrest.

"These patients are very vulnerable, and if they're not in care, they're not getting medications, which likely means they're going to progress on to AIDS and unfortunately, probably an earlier death than they should have," Dillingham said.

And while the clinic makes reminder calls to patients about upcoming appointments, Sarah Delgado, assistant professor and nurse practitioner at U.Va., said a cell phone's omnipresence allows for daily contact with patients.

"We know the bill is paid, we know the phone is going to be good . . . that's why we think this might be a more effective mythos," Delgado said.

The program, open primarily to patients who have been out of treatment for at least six months, is structured to see whether the cell phones help keep HIV patients returning to care in line with treatments for longer than six months.

The program is designed to follow 20 people -- 10 with phones and 10 without.

Providers said they also see the texting program as something that could keep contact with and act as reminders for patients with other chronic diseases -- such as diabetes -- that require routine monitoring.

The program is being funded by a $25,000 grant given to U.Va.'s Rural Health Care Research Center by the National Institutes of Health. It has also received in-kind donations from locally based technology firm Silverchair and nTelos.

The study is scheduled to run through the end of 2009. After that, providers would like to repeat the study with more participants, Dillingham said.
Aaron Lee writes for The Daily Progress in Charlottesville.