Interventions to Improve Medication Adherence in Adolescents with HIV: A Systematic Review and Meta-analysis
Sasha W. Alcon, David Sloane, Billal Ahmed, Joseph S. Cervia. Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Garden City, New York, United States
Purpose of Study As of 2017, 1.8 million people living with HIV (PLWH) were adolescents between ages 10 -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 have increased approximately 50% among adolescents, and adolescent adherence to antiretroviral treatment (ART) is estimated at only 62% worldwide. While there have been great strides towards achieving the UN 90-90-90 goals, adolescents remain a group lacking appropriate resources and research to achieve these. This review synthesizes and analyzes current interventions aimed toward increasing adolescent ART adherence.
Methods Used Systematic searches of EMBASE, PubMed and PsycINFO were performed using the keywords “adolescent HIV medication adherence interventions.” In the meta-analysis, Cohen's d was calculated and used to estimate an overall study effect size, aggregating data across all measures. Finally, a random effects model was used to analyze intervention significance. Authors were contacted via e-mail to obtain additional data values and study clarification.
Summary of Results Twelve studies met the inclusion criteria for meta-analysis from our systematic review of the literature out of the sixty-three that were fully assessed for eligibility. Overall, there was no significant differences seen between control and intervention groups in medication adherence (p = 0.4861, SE = 0.1174).
Conclusions 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.
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