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. 2022 Oct;15(10):1053-1060.
doi: 10.1016/j.jiph.2022.08.012. Epub 2022 Aug 28.

Systematic review of interventions aimed at improving HIV adherence to care in low- and middle-income countries in Sub-Saharan Africa

Laura E Pugh  1 , Jacob S Roberts  1 , Nikita Viswasam  2 , Elizabeth Hahn  2 , Sophia Ryan  2 , Ghilane Turpin  2 , Carrie E Lyons  2 , Stefan Baral  2 , Bhakti Hansoti  3
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Systematic review of interventions aimed at improving HIV adherence to care in low- and middle-income countries in Sub-Saharan Africa

Laura E Pugh et al. J Infect Public Health. 2022 Oct.

Abstract

Long-term adherence to antiretroviral medication continues to present as a challenge along the continuum of the HIV care cascade. HIV interventions and support programs are significantly threatened in resource-limited settings by challenges in maintaining long-term follow-up for ART adherence. We sought to complete a systematic review to comprehensively examine ART adherence and retention in care interventions in Sub-Saharan Africa and to report on the implementation of interventions in real-world settings to inform future health investments in HIV care. Interventions were grouped according to their impact on individual, community, and health-systems levels. While a vast majority of studies evaluated a combination of interventions, those studies that incorporated the community as a resource were most successful. In addition, providing education and behavior reminders proved effective and should be accompanied by community and peer efforts for best results. Multi-level interventions, such as combining individual and community-level interventions showed promising results for long term ART adherence.

Keywords: Adherence; Human immunodeficiency virus (HIV); Sub-Saharan Africa; Systematic analysis.

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Figures

Figure 1.
Figure 1.
PRISMA diagram of systematic review flow.
Figure 2.
Figure 2.
Adherence interventions framework.
See this image and copyright information in PMC

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