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Active recall to increase HIV and STI testing: a systematic review
Monica Desai1, Sarah C Woodhall1, Anthony Nardone2
1HIV & STI Department, Public Health England, London, UK Research Department of Infection and Population Health, University College London, London, UK.
Sexually Transmitted Infections
|March 12, 2015
Summary
Active recall strategies significantly boost reattendance and retesting for HIV and sexually transmitted infections (STIs). Home sampling and SMS reminders show promise, but more research is needed to determine optimal methods.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Health Services Research
Background:
- Active recall strategies can improve patient reattendance and retesting rates for HIV and STIs.
- The optimal strategy for implementing active recall in HIV/STI testing remains unclear.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of active recall interventions for HIV and/or STI testing.
- To identify which active recall modalities are most effective in increasing reattendance and retesting rates.
Main Methods:
- Systematic review and meta-analysis of randomized, non-randomized, and observational studies.
- Searched six electronic databases for studies published between 1983 and 2013.
- Included studies reporting reattendance/retesting rates and STI diagnosis at follow-up.
Main Results:
- 17 studies met inclusion criteria; 14 demonstrated higher reattendance/retesting rates with active recall.
- Meta-analysis of nine RCTs showed significantly higher reattendance/retesting rates (pooled OR 2.42).
- Home sampling (pooled OR 2.20) and SMS reminders (pooled OR 2.19) increased retesting, though with high heterogeneity.
Conclusions:
- Active recall interventions are associated with increased reattendance and retesting for HIV/STI.
- Home sampling and SMS reminders show potential but require further investigation due to study heterogeneity and quality limitations.
- Further research is needed to determine the most clinically cost-effective and acceptable active recall methods for HIV/STI screening.
