Department of Psychology, University of Washington, Campus Box 351525, Seattle, WA 98195, USA.
Curr Infect Dis Rep. 2008 Nov;10(6):515-21. doi: 10.1007/s11908-008-0083-y.
The success of antiretroviral therapy (ART) for HIV infection, though widespread and resounding, has been limited by inadequate adherence to its unforgiving regimens, especially over the long term. This article summarizes the literature on behavioral interventions to promote ART adherence and highlights some of the most recent and innovative research on patient education and case management, modified directly observed therapy, contingency management, interventions emphasizing social support, and novel technologies to promote awareness. Research in the area of adherence in pediatric HIV infection and in resource-constrained international settings also is considered. Although adherence interventions have been successful in experimental trials, they may not be feasible or adaptable given the constraints of real-world clinics and community-based settings. Implementation and dissemination of adherence interventions needs increased attention as ART adherence research moves beyond its first decade. We conclude with suggestions for incorporating research findings into clinical practice.
抗逆转录病毒疗法（ART）在 HIV 感染方面的成功虽然广泛而显著，但由于未能完全遵守严格的治疗方案，尤其是在长期治疗方面，其效果受到了限制。本文总结了促进抗逆转录病毒治疗依从性的行为干预措施方面的文献，并重点介绍了一些最近和创新性的关于患者教育和病例管理、改良直接观察治疗、条件性管理、强调社会支持的干预措施以及促进意识的新技术的研究。还考虑了儿科 HIV 感染和资源有限的国际环境中的依从性研究。尽管在实验性试验中，依从性干预措施取得了成功，但鉴于实际临床和社区环境的限制，这些措施可能不可行或不适应。随着抗逆转录病毒治疗依从性研究进入其第一个十年，需要更加关注将依从性干预措施付诸实施和推广。我们最后提出了将研究结果纳入临床实践的建议。
