Details:

Alternative Title:
AIDS
Publisher's site:
http://dx.doi.org/10.1097/QAD.0000000000000879
Personal Author:
Crepaz, Nicole ; Baack, Brittney N. ; Higa, Darrel H. ; Mullins, Mary M.
Crepaz, Nicole ; Baack, Brittney N. ; Higa, Darrel H. ; Mullins, Mary M. Less -
Description:
Background

Reducing HIV infection and improving outcomes along the continuum of HIV care are high priorities of the U.S. National HIV/AIDS Strategy. Interventions that target multiple problem behaviors simultaneously in an integrated approach (referred to as integrated interventions) may improve prevention and care outcomes of persons living with HIV (PLWH). This systematic review and meta-analysis examines the effects of integrated interventions.

Methods

A systematic review, including both electronic and hand searches, was conducted to identify randomized controlled trials (RCTs) published between 1996 and 2014 that were designed to target at least two of the following behaviors among PLWH: HIV transmission risk behaviors, HIV care engagement, and medication adherence. Effect sizes (ESs) were meta-analyzed using random-effects models.

Results

Fifteen RCTs met the inclusion criteria. Integrated interventions significantly reduced sex without condoms (odds ratio [OR] = 0.74, 95% CI = 0.59, 0.94, p = .013, 13 ESs) and had marginally significant effects on improving medication adherence behaviors (OR = 1.35, 95% CI = 0.98, 1.85, p = .063, 12 ESs) and undetectable viral load (OR = 1.46, 95% CI= 0.93, 2.27, p = .098, 7 ESs). Significant intervention effects on at least two outcomes were seen in RCTs tailored to individual needs, delivered one-on-one, or in settings where PLWH received services or care.

Conclusions

Integrated interventions produced some favorable prevention and care continuum outcomes in PLWH. How to incorporate integrated interventions with other Combination HIV Prevention strategies to reach the optimal impact requires further research.


Subjects:
[+]
Article Continuity Of Patient Care Delivery Of Health Care, Integrated Disease Transmission, Infectious HIV Infections Humans Medication Adherence Risk-Taking Risk Assessment
Source:
AIDS. 29(18):2371-2383.
Pubmed ID:
26372483
Pubmed Central ID:
PMC4644116
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:14d0ae1a23592f2c24f8b020f0383ae7519629217e597b1124c00d0162d3b4e6
Download URL:
https://stacks.cdc.gov/view/cdc/36481/cdc_36481_DS1.pdf
File Type:

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