Damulak Panmial Priscilla, Ismail Suriani, Abdul Manaf Rosliza, Mohd Said Salmiah, Agbaji Oche
Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia.
Department of Public Health, Faculty of Basic Medical Sciences, Baze University, Abuja, Plot 686, Cadastral Zone C 00, Nigeria.
Int J Environ Res Public Health. 2021 Mar 3;18(5):2477. doi: 10.3390/ijerph18052477.
Optimal adherence to antiretroviral therapy (ART) remains the bedrock of effective therapy and management of human immunodeficiency virus (HIV). This systematic review examines the effect of interventions in improving ART adherence in sub-Saharan Africa (SSA), which bears the largest global burden of HIV infection. In accordance with PRISMA guidelines, and based on our inclusion and exclusion criteria, PUBMED, MEDLINE, and Google Scholar databases were searched for published studies on ART adherence interventions from 2010 to 2019. Thirty-one eligible studies published between 2010 to 2019 were identified, the categories of interventions were structural, behavioral, biological, cognitive, and combination. Study characteristics varied across design, intervention type, intervention setting, country, and outcome measurements. Many of the studies were behavioral interventions conducted in hospitals with more studies being randomized controlled trial (RCT) interventions. Despite the study variations, twenty-four studies recorded improvements. Notwithstanding, more quality studies such as RCTs should be conducted, especially among key affected populations (KAPs) to control transmission of resistant strains of the virus. Reliable objective measures of adherence should replace the conventional subjective self-report. Furthermore, long-term interventions with longer duration should be considered when evaluating the effectiveness of interventions.
最佳坚持抗逆转录病毒疗法（ART）仍然是有效治疗和管理人类免疫缺陷病毒（HIV）的基石。本系统综述考察了在撒哈拉以南非洲（SSA）开展的干预措施对提高ART依从性的效果，该地区承受着全球最大的HIV感染负担。根据PRISMA指南，并基于我们的纳入和排除标准，对PUBMED、MEDLINE和谷歌学术数据库进行检索，以查找2010年至2019年期间关于ART依从性干预措施的已发表研究。确定了2010年至2019年期间发表的31项符合条件的研究，干预措施的类别包括结构、行为、生物、认知和综合干预。研究特征在设计、干预类型、干预环境、国家和结果测量方面各不相同。许多研究是在医院开展的行为干预措施，更多的研究是随机对照试验（RCT）干预措施。尽管研究存在差异，但有24项研究记录了改善情况。尽管如此，仍应开展更多高质量研究，如RCT研究，尤其是在关键受影响人群（KAPs）中开展此类研究，以控制病毒耐药菌株的传播。可靠的客观依从性测量方法应取代传统的主观自我报告。此外，在评估干预措施的有效性时，应考虑持续时间更长的长期干预措施。
