Service delivery interventions to improve adolescents' linkage, retention and adherence to antiretroviral therapy and HIV care.
Service delivery interventions to improve adolescents' linkage, retention and adherence to antiretroviral therapy and HIV care.
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DOI：
10.1111/tmi.12517
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发表时间：
2015-08
期刊：
影响因子：
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通讯作者：
Ross DA
中科院分区：
文献类型：
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作者：
MacPherson P;Munthali C;Ferguson J;Armstrong A;Kranzer K;Ferrand RA;Ross DA
感染艾滋病毒的青少年在获得艾滋病毒护理服务方面面临很大困难，治疗结果比其他年龄组更差。本综述的目的是评估服务提供干预措施的有效性，以改善青少年的联系，从艾滋病毒诊断到抗逆转录病毒治疗（ART）的启动，保留在艾滋病毒的护理和坚持ART。我们系统地搜索了Medline，SCOPUS和Web的科学数据库和国际艾滋病大会和国际艾滋病和性传播感染会议在非洲（ICASA）的会议摘要。纳入了2001年1月1日至2014年6月9日期间以英文发表的研究。两位作者独立评价了报告的合格性，提取了数据，并使用科克伦偏倚风险工具和Newcastle-Ottawa量表评估了方法学质量。来自9个国家的11项研究符合审查条件。3项研究为随机对照试验。评估的干预措施包括个人和团体咨询和教育;同伴支持;直接观察治疗;经济激励;以及改善诊所对青少年友好的干预措施。大多数研究的方法学质量较低至中等。这项审查确定了有限的证据，表明服务提供干预措施的有效性，以支持青少年从艾滋病毒诊断到开始抗逆转录病毒治疗的联系，保持抗逆转录病毒治疗和坚持抗逆转录病毒治疗。增加诊所的可及性和提供针对青少年的具体服务似乎是有希望的干预措施，值得进一步调查。
Adolescents living with HIV face substantial difficulties in accessing HIV care services and have worse treatment outcomes than other age groups. The objective of this review was to evaluate the effectiveness of service delivery interventions to improve adolescents' linkage from HIV diagnosis to antiretroviral therapy (ART) initiation, retention in HIV care and adherence to ART. We systematically searched the Medline, SCOPUS and Web of Sciences databases and conference abstracts from the International AIDS Conference and International Conference on AIDS and STIs in Africa (ICASA). Studies published in English between 1st January 2001 and 9th June 2014 were included. Two authors independently evaluated reports for eligibility, extracted data and assessed methodological quality using the Cochrane risk of bias tool and Newcastle–Ottawa Scale. Eleven studies from nine countries were eligible for review. Three studies were randomised controlled trials. Interventions assessed included individual and group counselling and education; peer support; directly observed therapy; financial incentives; and interventions to improve the adolescent‐friendliness of clinics. Most studies were of low to moderate methodological quality. This review identified limited evidence on the effectiveness of service delivery interventions to support adolescents' linkage from HIV diagnosis to ART initiation, retention on ART and adherence to ART. Although recommendations are qualified because of the small numbers of studies and limited methodological quality, offering individual and group education and counselling, financial incentives, increasing clinic accessibility and provision of specific adolescent‐tailored services appear promising interventions and warrant further investigation.