Psychosocial interventions for improving engagement in care and health and behavioural outcomes for adolescents and young people living with HIV: a systematic review and meta-analysis.
Psychosocial interventions for improving engagement in care and health and behavioural outcomes for adolescents and young people living with HIV: a systematic review and meta-analysis.
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DOI：
10.1002/jia2.25741
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发表时间：
2021-08
影响因子：
6
通讯作者：
Skeen S
中科院分区：
文献类型：
--
作者：
Laurenzi CA;du Toit S;Ameyan W;Melendez-Torres GJ;Kara T;Brand A;Chideya Y;Abrahams N;Bradshaw M;Page DT;Ford N;Sam-Agudu NA;Mark D;Vitoria M;Penazzato M;Willis N;Armstrong A;Skeen S
青少年和年轻人在全球艾滋病毒新感染者中所占比例越来越大，但目前的方法无法有效地吸引这一群体，青少年艾滋病毒相关结果在所有年龄组中最差。提供心理社会干预措施，包括心理，社会和/或行为方法提供了一个潜在的途径，以改善青少年和青年艾滋病毒感染者（AYPLHIV）的护理和健康和行为结果的参与。通过四个电子数据库（科克伦图书馆、PsycINFO、PubMed和Scopus）对2000年1月至2020年7月期间发表的所有同行评审论文进行了系统检索。我们纳入了随机对照试验，评估旨在改善10至24岁AYPLHIV患者的护理和健康以及行为结果的心理社会干预措施。确定了30项相关研究。研究在美国（n = 18，60%）、撒哈拉以南非洲（尼日利亚、南非、乌干达、赞比亚、津巴布韦）和东南亚（泰国）进行。感兴趣的结果包括坚持抗逆转录病毒疗法、抗逆转录病毒疗法知识、病毒载量数据、性风险行为、性风险知识、继续接受护理以及与护理的联系。总体而言，针对AYPLHIV的心理社会干预对ART依从性（SMD = 0.3907，95%CI：0.1059至0.6754，21项研究，n = 2647）和病毒载量（SMD =-0.2607，95%CI-04518至-0.0696，12项研究，n = 1566）显示出重要的小至中度影响。审查的心理社会干预措施没有显示出对AYPLHIV患者的护理保留（n = 8），性风险行为和知识（n = 13），病毒抑制（n = 4），无法检测的病毒载量（n = 5）或与护理的联系（n = 1）的显着影响。没有研究衡量向成人服务的过渡。有效的干预措施采用了各种方法，包括数字化和非专业卫生工作者交付，这有望在COVID-19背景下扩大干预措施。本综述强调了心理社会干预在改善艾滋病毒感染者健康状况方面的潜力。然而，需要对能够有效减少艾滋病毒/艾滋病感染者性风险行为的干预措施以及能够加强护理参与的干预措施进行更多的研究。面对资源限制和COVID-19大流行等全球挑战，需要进一步投资，以确保这些干预措施具有成本效益、可持续性和弹性。
Adolescents and young people comprise a growing proportion of new HIV infections globally, yet current approaches do not effectively engage this group, and adolescent HIV‐related outcomes are the poorest among all age groups. Providing psychosocial interventions incorporating psychological, social, and/or behavioural approaches offer a potential pathway to improve engagement in care and health and behavioural outcomes among adolescents and young people living with HIV (AYPLHIV). A systematic search of all peer‐reviewed papers published between January 2000 and July 2020 was conducted through four electronic databases (Cochrane Library, PsycINFO, PubMed and Scopus). We included randomized controlled trials evaluating psychosocial interventions aimed at improving engagement in care and health and behavioural outcomes of AYPLHIV aged 10 to 24 years. Thirty relevant studies were identified. Studies took place in the United States (n = 18, 60%), sub‐Saharan Africa (Nigeria, South Africa, Uganda, Zambia, Zimbabwe) and Southeast Asia (Thailand). Outcomes of interest included adherence to antiretroviral therapy (ART), ART knowledge, viral load data, sexual risk behaviours, sexual risk knowledge, retention in care and linkage to care. Overall, psychosocial interventions for AYPLHIV showed important, small‐to‐moderate effects on adherence to ART (SMD = 0.3907, 95% CI: 0.1059 to 0.6754, 21 studies, n = 2647) and viral load (SMD = −0.2607, 95% CI −04518 to −0.0696, 12 studies, n = 1566). The psychosocial interventions reviewed did not demonstrate significant impacts on retention in care (n = 8), sexual risk behaviours and knowledge (n = 13), viral suppression (n = 4), undetectable viral load (n = 5) or linkage to care (n = 1) among AYPLHIV. No studies measured transition to adult services. Effective interventions employed various approaches, including digital and lay health worker delivery, which hold promise for scaling interventions in the context of COVID‐19. This review highlights the potential of psychosocial interventions in improving health outcomes in AYPLHIV. However, more research needs to be conducted on interventions that can effectively reduce sexual risk behaviours of AYPLHIV, as well as those that can strengthen engagement in care. Further investment is needed to ensure that these interventions are cost‐effective, sustainable and resilient in the face of resource constraints and global challenges such as the COVID‐19 pandemic.
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影响因子：
1.7
作者：
Bhana A;Mellins CA;Petersen I;Alicea S;Myeza N;Holst H;Abrams E;John S;Chhagan M;Nestadt DF;Leu CS;McKay M
通讯作者：
McKay M
影响因子：
4.4
作者：
Christodoulou, Joan;Abdalian, Sue Ellen;Rotheram-Borus, Mary Jane
通讯作者：
Rotheram-Borus, Mary Jane
影响因子：
4.4
作者：
Belzer, Marvin E.;Naar-King, Sylvie;Olson, Johanna;Sarr, Moussa;Thornton, Sarah;Kahana, Shoshana Y.;Gaur, Aditya H.;Clark, Leslie F.
通讯作者：
Clark, Leslie F.
DOI：
10.1080/09540120701867099
发表时间：
2008-01-01
影响因子：
1.7
作者：
Bakeera-Kitaka, Sabrina;Nabukeera-Barungi, Nicolette;Colebunders, Robert
通讯作者：
Colebunders, Robert
DOI：
10.1097/qai.0000000000000803
发表时间：
2016-01-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Brown LK;Kennard BD;Emslie GJ;Mayes TL;Whiteley LB;Bethel J;Xu J;Thornton S;Tanney MR;Hawkins LA;Garvie PA;Subramaniam GA;Worrell CJ;Stoff LW;Adolescent Trials Network for HIVAIDS Interventions
通讯作者：
Adolescent Trials Network for HIVAIDS Interventions