School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada.
AIDS Behav. 2020 Apr;24(4):998-1022. doi: 10.1007/s10461-019-02690-7.
Adherence to antiretroviral therapy (ART) is essential to reduce morbidity and mortality among people living with HIV (PLWH). However, adherence remains suboptimal, and PLWH may benefit from more self-management support to address the complexities of chronic illness. Our objective was to identify the impact of peer-led self-management interventions on adherence and patient-reported outcomes (PROs) among PLWH. We searched MEDLINE, PubMed, Embase, PsycINFO, and CINAHL for English language publications from 1996 to March 2018, and included controlled intervention studies. Additional articles were handsearched, risk of bias assessed, and narrative syntheses outlined. Thirteen studies met inclusion criteria. Findings demonstrate unclear effectiveness for peer-led self-management interventions improving ART adherence; however evidence was limited with only seven studies measuring this outcome and some risk of bias. Many PROs were measured, with limited consistent findings. Future research is needed to strengthen the evidence regarding effects of peer-led self-management interventions on adherence and PROs among PLWH.
抗逆转录病毒疗法 (ART) 的依从性对于降低艾滋病毒感染者 (PLWH) 的发病率和死亡率至关重要。然而，依从性仍然不理想，PLWH 可能受益于更多的自我管理支持，以解决慢性病的复杂性。我们的目的是确定同伴主导的自我管理干预对 PLWH 的依从性和患者报告的结果 (PROs) 的影响。我们检索了 1996 年至 2018 年 3 月期间发表的英文文献，包括 MEDLINE、PubMed、Embase、PsycINFO 和 CINAHL，并纳入了对照干预研究。还进行了手工检索，评估了偏倚风险，并概述了叙述性综合。有 13 项研究符合纳入标准。研究结果表明，同伴主导的自我管理干预对改善 ART 依从性的效果不明确；然而，证据有限，只有 7 项研究测量了这一结果，并且存在一定的偏倚风险。许多 PROs 得到了测量，但一致性发现有限。需要进一步研究来加强关于同伴主导的自我管理干预对 PLWH 的依从性和 PROs 的影响的证据。
