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Keynote webinar | Spotlight on medication adherence

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AIDS and Behavior
Published in: AIDS and Behavior 7/2017

01-07-2017 | Substantive Review

Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review

Authors: Kathryn A. Risher, Sunaina Kapoor, Alice Moji Daramola, Gabriela Paz-Bailey, Jacek Skarbinski, Kate Doyle, Kate Shearer, David Dowdy, Eli Rosenberg, Patrick Sullivan, Maunank Shah

Published in: AIDS and Behavior | Issue 7/2017

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Abstract

In the United States (US), there are high levels of disengagement along the HIV care continuum. We sought to characterize the heterogeneity in research studies and interventions to improve care engagement among people living with diagnosed HIV infection. We performed a systematic literature search for interventions to improve HIV linkage to care, retention in care, reengagement in care and adherence to antiretroviral therapy (ART) in the US published from 2007-mid 2015. Study designs and outcomes were allowed to vary in included studies. We grouped interventions into categories, target populations, and whether results were significantly improved. We identified 152 studies, 7 (5%) linkage studies, 33 (22%) retention studies, 4 (3%) reengagement studies, and 117 (77%) adherence studies. ‘Linkage’ studies utilized 11 different outcome definitions, while ‘retention’ studies utilized 39, with very little consistency in effect measurements. The majority (59%) of studies reported significantly improved outcomes, but this proportion and corresponding effect sizes varied substantially across study categories. This review highlights a paucity of assessments of linkage and reengagement interventions; limited generalizability of results; and substantial heterogeneity in intervention types, outcome definitions, and effect measures. In order to make strides against the HIV epidemic in the US, care continuum research must be improved and benchmarked against an integrated, comprehensive framework.
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Metadata
Title
Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review
Authors
Kathryn A. Risher
Sunaina Kapoor
Alice Moji Daramola
Gabriela Paz-Bailey
Jacek Skarbinski
Kate Doyle
Kate Shearer
David Dowdy
Eli Rosenberg
Patrick Sullivan
Maunank Shah
Publication date
01-07-2017
Publisher
Springer US
Published in
AIDS and Behavior / Issue 7/2017
Print ISSN: 1090-7165
Electronic ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-017-1687-8

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