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Interventions delivered by mobile phone can be effective in improving a range of behaviours such as smoking cessation, adherence to medication and contraceptive uptake.6–14 There is some evidence that mobile phone support can increase safer sex behaviours; however, high-quality trials are needed to reliably establish effects.15 A trial evaluating an intervention consisting of eight safer sex text messages, aimed at increasing knowledge and perceived behavioural control, reinforcing safer sex behaviours and changing attitudes, found that intervention participants were more likely to report using condoms with new partners in the previous 3 months compared with controls who received text messages not about safer sex (OR 2.2, 95% CI 1.1 to 4.2).However, this trial found little evidence for an intervention effect on always using condoms in the previous 6 months (OR 0.8, 95% CI 0.5 to 1.4).16 An intervention consisting of 14 ‘short and catchy’ text messages providing advice and information about sexually transmitted infection (STI), increased STI testing in women compared with control participants who did not receive the messages (OR 2.51, 95% CI 1.11 to 5.69).17 A trial of an intervention aimed at retesting following a positive chlamydia test result found a fourfold increase in testing in participants that received text message reminders versus controls that received the standard advice from a clinician (RR 4.5, 95% CI 1.05 to 19.22).18 None of these trials had a low risk of bias or targeted partner notification.Safetxt was developed drawing on: behavioural science; face-to-face interventions; the factors known to influence safer sex behaviours and the views of young people.Results We recruited 200 participants within our target of 3 months and we achieved 81% (162/200) follow-up response for the proposed primary outcome of the main trial, cumulative incidence of chlamydia at 12 months.This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited.

Our texting software automatically delivered the intervention or control messages to the mobile phone number that participants provided at enrolment.We gave all potential participants detailed verbal and written information, the opportunity to ask questions and time to consider their participation.For participants recruited by telephone, the trial manager emailed or texted the link to the web-based information sheet and participants provided informed consent by completing the form on the secure study website.The 1-month questionnaire also collected data on participants' views of the messages.We gathered participant views at 1 month because around half of the messages were delivered within this period and we wanted to maximise recall.

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