Please select the eligibility criteria that correspond to the clinical trial below.
Title: Adherence to ARV Treatment and Its Effects on Medium Run Socio-Economic Outcomes: Evidence From Western Kenya
Brief Summary: The purpose of proposed research is to implement a randomized study that will allow us to understand and address a number of key barriers to patient adherence as well as study the effects of better adherence on health and socio-economic outcomes.


Options:
A: Inclusion Criteria:

* Age 21 years or more
* Linked using EMR data to a HealthPartners Medical Group primary care clinic
* Within the 12-month period of time prior to screening have had at least 2 primary care outpatient encounters, in the two most recent of which the blood pressure was above Joint National Committee 7 (JNC7) goal (\<140/90 mmHg or \<130/80 for patients with diabetes or kidney disease).
* Have a measured blood pressure at a research clinic screening visit above the JNC7 goal

Exclusion Criteria:

* Acute coronary syndrome or stroke within the past 3 months
* Class III (marked limitation of physical activity) or IV (symptoms at rest) New York Heart Association heart failure, or known left ventricular ejection fraction (\<30%)
* Severe renal dysfunction, with epidermal growth factor receptor (eGFR) ,30 ml/min/1.73 m2 using the abbreviated Modification of Diet in Renal Disease Study (MDRD) equation
* Known secondary causes of hypertension such as coarctation of the aorta, pheochromocytoma, adrenal cortical hypertension or renal vascular hypertension
* Unwillingness to be followed for a period of 18 months
* Pregnancy or unwillingness to use reliable bith control for females of child-bearing age
* Participation in another clinical trial
* Requires an interpreter to communicate with health care providers
* Dementia, mental illness or any condition that would limit ability to give informed consent
B: Inclusion Criteria:

* Age 18 years or older
* Hypertension
* BP \> 140/90 mmHg or \> 130/80 mmHg if patient has diabetes at the initial screening visit using an approved automated BP monitor.
* If on drug therapy, continuous drug therapy with the same dosing interval for 8 weeks prior to and throughout the screening period. May be drug naive.
* Written informed consent
* Hypertension for at least 12 weeks before screening and throughout the screening period (according to the patient or their medical practitioner)
* Must have a cell phone plan (in Canada) and be willing to maintain the plan during the study. For Tanzania, must have a cell phone under a locally available Tanzanian carrier.
* Must be willing to take occasional local calls from study team members
* One or more of BMI \> 30 kg/m2, diabetes, smoking, over age 40, previous history of CAD including stroke and heart attack
* An identified health care provider in the community (ie. Family Physician/Nurse Practitioner in Canada or Community Nurse/Clinical officer in Tanzania)

Exclusion Criteria:

* Change in antihypertensive medication during the 8 weeks before enrolment
* No cell phone plan compatible with the study.
* Poorly controlled hypertension with BP \> 180/110 mmHg
* No primary health care provider
* Active malignant disease (except non-melanoma skin cancer)
* Unable or unwilling to visit health care provider
* Unable to read the SMS messages (English in Canada and Kiswahili in Tanzania)
* Participation in a clinical trial or receipt of investigational compound or treatment in the 3 months prior to the initial screening visit.
* Planned elective surgery during the study period except for cataract surgery
* \*For BP screening study, must not be on an antihypertensive in the last 6 months.
C: Inclusion Criteria:

* HIV infected and starting antiretroviral therapy
* Adequate (daily) access to a cell phone
* Intending to attend the enrollment clinic for 2 years
* Consent to participate

Exclusion Criteria:

* Not meeting inclusion criteria
D: Inclusion Criteria:

* Patients who had been on ARV therapy at the Chulaimbo Rural Health Center for a maximum of three months and providing consent to participate in the study.

Exclusion Criteria:

* Patients who had been on ARV therapy for more than 3 months.

Answer: D