BRIEF REPORT Designing a Mobile Phone-Based Intervention to Promote Adherence to Antiretroviral Therapy in South India Anita Shet • Karthika Arumugam • Rashmi Rodrigues • Nirmala Rajagopalan • K. Shubha • Tony Raj • George D’souza • Ayesha De Costa Ó Springer Science+Business Media, LLC 2010 Abstract Integration of mobile phone technology into HIV care holds potential, particularly in resource-con- strained settings. Clinic attendees in urban and rural South India were surveyed to ascertain usage of mobile phones and perceptions of their use as an adherence aid. Mobile phone ownership was high at 73%; 26% reported shared ownership. A high proportion (66%) reported using phones to call their healthcare provider. There was interest in weekly telephonic automated voice reminders to facilitate adherence. Loss of privacy was not considered a deterrent. The study presents important considerations in the design of a mobile phone-based adherence intervention in India. Keywords Mobile phones Á Adherence Á HIV Á Antiretroviral therapy Introduction There has been recent interest in the potential use of mobile phone technology for different aspects of healthcare par- ticularly in low-income settings [1–3]. Presently, 64% of all mobile phone users are in the developing world [4]. The growing ubiquity of mobile phones is a central element in the promise of mobile technologies for health [5]. While there have been a number of studies integrating mobile phones in the care of chronic conditions such as diabetes and asthma, interest has been evoked specifically in the area of HIV [2]. Access to HIV care and treatment in India has improved dramatically as a result of efforts by the National AIDS Control Organization (NACO) and the number of people accessing antiretroviral therapy (ART) has crossed 200,000 in 2008 [6]. Adherence is a key issue in treatment success as poor adherence contributes to the development of resistance and need for expensive second-line ART regimens. The role of mobile tele- phones in promoting adherence to ART has not been extensively explored in the literature. India is particularly suited for a mobile telephone-based intervention given the widespread connectivity, low costs and growing popularity of the mobile phone. The survey reported here was planned as a preliminary study prior to the initiation of a randomized trial on the influence of mobile phones on adherence to ART in South India. Specifically, the survey was intended to explore the pattern of use of mobile phones among patients, and understand patients’ perceptions of a potential mobile phone-based interven- tion to promote adherence in this setting. The appropri- ateness of the intervention in this setting and implications of the preliminary study findings are discussed in this report. Electronic supplementary material The online version of this article (doi:10.1007/s10461-009-9658-3) contains supplementary material, which is available to authorized users. A. Shet (&) Department of Pediatrics, St John’s National Academy of Health Sciences, Bangalore, India e-mail: anitashet@gmail.com A. Shet Á A. De Costa Division of International Health, Karolinska Institutet, Stockholm, Sweden K. Arumugam Á R. Rodrigues Á K. Shubha Á T. Raj Á G. D’souza Á A. De Costa St John’s National Academy of Health Sciences, Bangalore, India N. Rajagopalan Freedom Foundation, Bangalore, India 123 AIDS Behav DOI 10.1007/s10461-009-9658-3