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. 2011 Dec;11(12):942-51.
doi: 10.1016/S1473-3099(11)70181-5. Epub 2011 Oct 24.

Interventions to increase antiretroviral adherence in sub-Saharan Africa: a systematic review of evaluation studies

Till Bärnighausen  1 , Krisda Chaiyachati, Natsayi Chimbindi, Ashleigh Peoples, Jessica Haberer, Marie-Louise Newell
Affiliations

Interventions to increase antiretroviral adherence in sub-Saharan Africa: a systematic review of evaluation studies

Till Bärnighausen et al. Lancet Infect Dis. 2011 Dec.

Abstract

The success of potent antiretroviral treatment for HIV infection is primarily determined by adherence. We systematically review the evidence of effectiveness of interventions to increase adherence to antiretroviral treatment in sub-Saharan Africa. We identified 27 relevant reports from 26 studies of behavioural, cognitive, biological, structural, and combination interventions done between 2003 and 2010. Despite study diversity and limitations, evidence suggests that treatment supporters, directly observed therapy, mobile-phone text messages, diary cards, and food rations can effectively increase adherence in sub-Saharan Africa. However, some interventions are unlikely to have large or lasting effects, and others are effective only in specific settings. These findings emphasise the need for more research, particularly for randomised controlled trials, to examine the effect of context and specific features of intervention content on effectiveness. Future work should assess intervention targeting and selection of interventions based on behavioural theories relevant to sub-Saharan Africa.

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Figures

Figure 1
Figure 1
Flowchart of the systematic review
See this image and copyright information in PMC

Comment in

  • Antiretroviral therapy requires life-long adherence.
    de Pee S, Grede N, Forsythe M, Bloem MW. de Pee S, et al. Lancet Infect Dis. 2012 Sep;12(9):661-2; author reply 662. doi: 10.1016/S1473-3099(12)70170-6. Lancet Infect Dis. 2012. PMID: 22917099 No abstract available.

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