Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Psychological Science, Northern Michigan University, Marquette, MI, USA.
AIDS Behav. 2022 Jun;26(6):1853-1862. doi: 10.1007/s10461-021-03534-z. Epub 2021 Nov 16.
Suppressing HIV viral loads to undetectable levels is essential for ending the HIV/AIDS epidemic. We evaluated randomized controlled trials aimed to increase antiretroviral medication adherence and promote undetectable viral loads among people living with HIV through November 22, 2019. We extracted data from 51 eligible interventions and analyzed the results using random effects models to compare intervention effects between groups within each intervention and across interventions. We also evaluated the relation between publication date and treatment effects. Only five interventions increased undetectable viral loads significantly. As a whole, the analyzed interventions were superior to Standard of Care in promoting undetectable viral loads. Interventions published more recently were not more effective in promoting undetectable viral loads. No treatment category consistently produced significant increases in undetectable viral loads. To end the HIV/AIDS epidemic, we should use interventions that can suppress HIV viral loads to undetectable levels.
抑制 HIV 病毒载量至不可检测水平对于终结 HIV/AIDS 大流行至关重要。我们评估了截至 2019 年 11 月 22 日旨在通过提高抗逆转录病毒药物的依从性并促进 HIV 感染者病毒载量不可检测的随机对照试验。我们从 51 项合格干预措施中提取数据,并使用随机效应模型分析结果,以比较每项干预措施内以及跨干预措施的组间干预效果。我们还评估了出版日期与治疗效果之间的关系。只有五项干预措施可显著提高病毒载量不可检测率。总的来说,与标准护理相比,所分析的干预措施在促进病毒载量不可检测方面效果更好。最近发表的干预措施在促进病毒载量不可检测方面并没有更有效。没有一个治疗类别始终能显著提高病毒载量不可检测率。为终结 HIV/AIDS 大流行,我们应采用可将 HIV 病毒载量抑制至不可检测水平的干预措施。