Christopoulos KA, et al. - Considering text messaging as a promising strategy to support human immunodeficiency virus (HIV) care engagement, researchers sought for its efficacy in urban safety-net HIV clinics. In this randomized controlled trial of a supportive and motivational text messaging intervention, Connect4Care (C4C), among viremic patients who had a history of poor retention or were new to the clinic, they randomized participants (stratified by new or established HIV diagnosis status) to receive either of the following for 12 months: (1) thrice-weekly intervention messages, plus texted primary care appointment reminders and a monthly text message requesting confirmation of study participation or (2) texted reminders and monthly messages alone. Outcomes revealed no significant increase in virologic suppression or retention in care with the implementation of the C4C text messaging intervention. They suggest the response to text messages as a valuable strategy for providers to gauge risk for poor HIV outcomes.