Mbuagbaw Lawrence, Mertz Dominik, Lawson Daeria O, Smieja Marek, Benoit Anita C, Alvarez Elizabeth, Puchalski Ritchie Lisa, Rachlis Beth, Logie Carmen, Husbands Winston, Margolese Shari, Thabane Lehana
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada.
BMJ Open. 2018 Sep 11;8(9):e022982. doi: 10.1136/bmjopen-2018-022982.
While access to antiretroviral therapy (ART) for people living with HIV has expanded in recent years, additional efforts are required to support adherence to medication and retention in care. Interventions should be applicable in real-world settings and amenable to widespread use. The objectives of this overview are to identify effective pragmatic interventions that increase adherence to ART and retention in care for people living with HIV at high risk for suboptimal adherence and retention in high-income countries.
We will conduct an overview of systematic reviews of studies on interventions which target improved adherence to medication and retention in care among high-risk people living with HIV in high-income countries (men who have sex with men, African, Caribbean and black people, sex workers, people who inject drugs, indigenous people and other socially marginalised groups). We will search the following databases: PubMed, EMBASE (Exerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO, Web of Science and the Cochrane Library. We will conduct screening, data extraction and assessment of methodological quality of the systematic reviews. Analysis will be narrative. Our findings will be interpreted in light of the certainty of the evidence, level of pragmatism, setting and population of interest.
Only published secondary data will be used in this study, and therefore ethics approval is not required. Our findings will be disseminated as peer-reviewed manuscripts, conference abstracts and through community activities. The findings from this overview will inform a mixed-methods study among people living with HIV and health workers in Ontario, Canada.
近年来，艾滋病毒感染者获得抗逆转录病毒疗法（ART）的机会有所增加，但仍需做出更多努力来支持药物依从性和持续接受治疗。干预措施应适用于现实世界环境并易于广泛应用。本综述的目的是确定有效的务实干预措施，以提高高收入国家中依从性和治疗留存率欠佳风险较高的艾滋病毒感染者的ART依从性和治疗留存率。
我们将对针对高收入国家中艾滋病毒高风险感染者（男男性行为者、非洲人、加勒比人和黑人、性工作者、注射吸毒者、原住民及其他社会边缘化群体）改善药物依从性和治疗留存率的干预措施研究的系统评价进行综述。我们将检索以下数据库：PubMed、EMBASE（医学文摘数据库）、CINAHL（护理学与健康相关文献累积索引）、PsycINFO、科学引文索引和Cochrane图书馆。我们将对系统评价进行筛选、数据提取和方法学质量评估。分析将采用叙述性方式。我们的研究结果将根据证据的确定性、务实程度、研究背景和目标人群进行解读。
本研究仅使用已发表的二手数据，因此无需伦理批准。我们的研究结果将以同行评审手稿、会议摘要以及通过社区活动的形式进行传播。本综述的结果将为加拿大安大略省艾滋病毒感染者和卫生工作者的一项混合方法研究提供参考。
