撒哈拉以南非洲地区 HIV 感染青少年的诊断告知与抗逆转录病毒治疗依从性之间的关联：系统评价和荟萃分析方案。
The association between diagnosis disclosure and adherence to antiretroviral therapy among adolescents living with HIV in sub-Saharan Africa: a protocol for systematic review and meta-analysis.
机构信息
School of Public Health, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
出版信息
Syst Rev. 2020 Jul 14;9(1):160. doi: 10.1186/s13643-020-01420-8.
INTRODUCTION
More than eight in ten of the world's 1.65 million adolescents living with human immunodeficiency virus (ALHIV) live in sub-Saharan Africa (SSA). Suboptimal adherence to antiretroviral therapy (ART) and poor viral suppression are reported among ALHIV which may in turn compromise the gains achieved so far. The evidence on whether knowing one's own human immunodeficiency virus (HIV) status and self-disclosure to others benefit adherence to ART or not is inconclusive. This review aims to estimate the association between knowing one's HIV status and self-disclosure on adherence to ART among ALHIV in SSA.
METHODS
Comprehensive search strings will be used to identify relevant observational studies published in English up to May 2020 in major databases: Excerpta Medica database (EMBASE), PubMed, and Ovid/MEDLINE. To access African studies and also to freely access subscription-based articles, the African Index Medicus (AIM) and the WHO HINARI databases will be searched. The AfroLib database will be searched to access the gray literature of African studies. We will use the COVIDENCE software for title/abstract screening, full-text screening, quality assessment, and data extraction. Two authors will independently screen retrieved articles, and a third author authorized to resolve conflicts will handle disagreements. The Joanna Briggs Institute's (JBI) critical appraisal tools will be used to assess study quality. Appropriate statistical tests will be conducted to quantify the between studies heterogeneity and for the assessment of publication bias. We will check individual study influence analysis and also do subgroup analysis. The STATA version 14.2 will be used for statistical analysis.
DISCUSSION
A high-level adherence to ART is required to achieve adequate viral suppression and improve quality of life. Consequently, the evidence on how adherence to ART differs with knowledge of one's own HIV status and self-disclosure may help guide interventions aimed at improving adherence to ART.
简介
在全球 165 万感染艾滋病毒的青少年中，超过 80%生活在撒哈拉以南非洲（SSA）。据报道，艾滋病毒抗体阳性的青少年人群中，抗逆转录病毒疗法（ART）的依从性不足和病毒抑制不佳的情况较为普遍，这可能会影响迄今为止取得的成果。关于了解自身艾滋病毒（HIV）状况和向他人披露自身状况是否有利于 ART 依从性的证据尚无定论。本综述旨在评估撒哈拉以南非洲地区艾滋病毒抗体阳性青少年了解自身 HIV 状况和向他人披露自身状况与 ART 依从性之间的关联。
方法
我们将使用全面的检索词在主要数据库（EMBASE 数据库、PubMed 和 Ovid/MEDLINE）中检索截至 2020 年 5 月发表的关于在撒哈拉以南非洲地区艾滋病毒抗体阳性青少年中了解自身 HIV 状况和向他人披露自身状况与 ART 依从性之间关联的相关观察性研究。为了获取非洲研究以及免费获取订阅数据库文章，将检索非洲医学索引（AIM）和世界卫生组织 HINARI 数据库。还将检索 AfroLib 数据库以获取非洲研究的灰色文献。我们将使用 COVIDENCE 软件进行标题/摘要筛选、全文筛选、质量评估和数据提取。两名作者将独立筛选检索到的文章，授权解决冲突的第三名作者将处理分歧。将使用乔安娜·布里格斯研究所（JBI）的批判性评估工具评估研究质量。将进行适当的统计检验，以量化研究间的异质性并评估发表偏倚。我们将检查个别研究的影响分析，并进行亚组分析。将使用 STATA 版本 14.2 进行统计分析。
讨论
需要高度的 ART 依从性才能实现充分的病毒抑制和提高生活质量。因此，关于 ART 依从性随了解自身 HIV 状况和自我披露情况而变化的证据可能有助于指导旨在提高 ART 依从性的干预措施。
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