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The effectiveness of treatment supporter interventions in antiretroviral treatment adherence in sub-Saharan Africa: a systematic review and meta-Analysis.
- Source :
- AIDS Care; 2020 Supplement, Vol. 32, p214-227, 14p, 1 Diagram, 4 Charts, 3 Graphs
- Publication Year :
- 2020
-
Abstract
- This systematic review and meta-analysis evaluated the effectiveness of treatment supporter interventions (TSI) in improving ART adherence and viral suppression among adults living with HIV (PLWH) in sub-Saharan Africa. This review included ten randomized controlled trials (RCT) and six cohort studies comparing treatment support interventions to the standard of care (SOC). Primary outcomes include pill count ART adherence and viral load suppression (VLS). Pooled relative risk ratios (PRR) with 95% confidence intervals were generated using random-effects models. Stratified analyses and meta-regressions were conducted to determine the effect of study type, follow-upperiod, and patient treatment supporters on ART adherence. Treatment supporters included partners, friends, family members, trained community health workers, and HIV positive peers. TSIs were associated with a 7.6% higher ART adherence compared to the SOC group (PRR = 1.076, [95% CI = 1.005, 1.151]). VLS was 5% higher in the treatment group compared to the SOC group (PRR = 1.05, [95% CI = 1.061, 1.207]). There was a significant, positive association between TSIs and VLS in community-based delivery settings but not in facility-based settings. TSIs were statistically significant for VLS in cohort study designs (RR = 1.073, [95% CI = 1.028, 1.121]) but not in RCTs. Findings suggest that TSIs critical in facilitating optimal ART adherence and VLS among PLWHs. [ABSTRACT FROM AUTHOR]
- Subjects :
- CLINICAL drug trials
COMMUNITY health services
CONFIDENCE intervals
DRUGS
FRIENDSHIP
HIV infections
HIV-positive persons
META-analysis
PATIENT compliance
PATIENT education
QUALITY assurance
REGRESSION analysis
SYSTEMATIC reviews
AFFINITY groups
VIRAL load
ANTIRETROVIRAL agents
SOCIAL support
HIGHLY active antiretroviral therapy
RELATIVE medical risk
TREATMENT effectiveness
EDUCATIONAL outcomes
HIV seroconversion
SEXUAL partners
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 09540121
- Volume :
- 32
- Database :
- Complementary Index
- Journal :
- AIDS Care
- Publication Type :
- Academic Journal
- Accession number :
- 142849074
- Full Text :
- https://doi.org/10.1080/09540121.2020.1742870