Interventions to improve medication adherence in adolescents with HIV: a systematic review and meta-analysis.

Autor:	Alcon S; Medical School, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA salcon1@pride.hofstra.edu., Ahmed B; Medical School, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Sloane D; Medical School, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA., Lim YS; Quantitative and Mixed Methods Research Methodologies, Educational Studies, University of Cincinnati, Cincinnati, Ohio, USA., Cervia JS; Departments of Medicine and Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York, USA.; Health Care Partners IPA & MSO, Garden City, New York, USA.
Jazyk:	angličtina
Zdroj:	Journal of investigative medicine : the official publication of the American Federation for Clinical Research [J Investig Med] 2020 Oct; Vol. 68 (7), pp. 1217-1222. Date of Electronic Publication: 2020 Jul 22.
DOI:	10.1136/jim-2020-001295
Abstrakt:	As of 2017, 1.8 million people living with HIV (PLWH) were adolescents between ages 10 and 19, accounting for 5% of all PLWH and 590,000 people between the ages 15 and 24 were newly infected with HIV. Between 2004 and 2011, AIDS-related deaths increased 50% among adolescents, and optimal adolescent adherence to antiretroviral treatment (ART) is estimated at only 62% of adolescents worldwide. While there have been great strides toward achieving the UNAIDS 90-90-90 goals, adolescents remain a group lacking appropriate resources and research to achieve these. This review analyzes current interventions aimed toward increasing adolescent ART adherence. Systematic searches of EMBASE, PubMed and PsycINFO were performed using the keywords 'adolescent HIV medication adherence interventions'. The Gain Score effect size was calculated for studies reporting the Cohen's d and variance to include both prestudy and poststudy values. A random-effects model analyzed intervention significance. Authors were contacted to obtain additional data values and study clarification. Twelve studies met inclusion criteria for meta-analysis. There were no significant differences seen between control and intervention groups in medication adherence (z=-1.4714, p<0.1412), viral load (z=-0.1946, p<0.8547) or CD4+ lymphocyte count (z=0.2650, p<0.7910). There was no significant difference between studies in increasing medication adherence. Results indicate that interventions did not improve medication adherence in adolescents with HIV. However, the paucity of quantitative research available speaks to a need for more quantitative intervention studies and standardization of measures of intervention efficacy. Competing Interests: Competing interests: None declared. (© American Federation for Medical Research 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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