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Health Technology-Enabled Interventions for Adherence Support and Retention in Care Among US HIV-Infected Adolescents and Young Adults: An Integrative Review

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Abstract

The objective of this integrative review was to describe current US trends for health technology-enabled adherence interventions among behaviorally HIV-infected youth (ages 13–29 years), and present the feasibility and efficacy of identified interventions. A comprehensive search was executed across five electronic databases (January 2005–March 2016). Of the 1911 identified studies, nine met the inclusion criteria of quantitative or mixed methods design, technology-enabled adherence and or retention intervention for US HIV-infected youth. The majority were small pilots. Intervention dose varied between studies applying similar technology platforms with more than half not informed by a theoretical framework. Retention in care was not a reported outcome, and operationalization of adherence was heterogeneous across studies. Despite these limitations, synthesized findings from this review demonstrate feasibility of computer-based interventions, and initial efficacy of SMS texting for adherence support among HIV-infected youth. Moving forward, there is a pressing need for the expansion of this evidence base.

Resumen

El objetivo de esta revisión integradora fue describir las tendencias actuales de los Estados Unidos para las intervenciones de adherencia habilitadas para la tecnología de la salud entre los jóvenes con VIH de 13 a 29 años de edad y presentar la viabilidad y eficacia de las intervenciones identificadas. Se realizó una búsqueda exhaustiva en cinco bases de datos electrónicas (enero de 2005 - marzo de 2016). De los 1911 estudios identificados, nueve cumplieron con los criterios de inclusión de diseño de métodos cuantitativos o mixtos, la tecnología de habilitación de la adherencia y/o retención de la intervención de EE.UU. La mayoría eran pequeños pilotos. La dosis de intervención varió entre los estudios que aplicaban plataformas tecnológicas similares con más de la mitad no informados por un marco teórico. La retención en la atención no fue un resultado informado, y la operacionalización de la adherencia fue heterogénea entre los estudios. A pesar de estas limitaciones, los hallazgos sintetizados de esta revisión demuestran la factibilidad de las intervenciones basadas en computadoras y la eficacia inicial de los mensajes SMS para el apoyo de adherencia entre los jóvenes infectados por el VIH. En el futuro, hay una urgente necesidad de la expansión de esta base de pruebas.

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Acknowledgements

This study was funded by a National Institute of Nursing Research (NINR) Career Development Award (K233NR015970-02): Adherence Connection Counseling, Education, and Support (ACCESS): A Proof of Concept Study.

Author Contribution

We gratefully acknowledge the contributions of Sonia Pathania, DNP, ANP, and Karla Rodriguez, DNP, RN.

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Authors and Affiliations

  1. Center for Drug Use and HIV Research, New York University Rory Meyers College of Nursing, 433 First Avenue Room 410, New York, NY, 10010, USA

    Ann-Margaret Dunn Navarra, Marya Viorst Gwadz, Charles M. Cleland, Winslow Burleson & Gail D’Eramo Melkus

  2. School of Nursing, Yale University, 400 West Campus Drive, Orange, CT, 06477, USA

    Robin Whittemore

  3. Department of Biomedical Informatics, Columbia University School of Nursing, 617 West 168th Street, New York, NY, 10032, USA

    Suzanne R. Bakken

  4. Elmer Holmes Bobst Library, New York University Libraries, 70 Washington Square South, New York, NY, 10012, USA

    Susan Kaplan Jacobs

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  1. Ann-Margaret Dunn Navarra
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Navarra, AM.D., Gwadz, M.V., Whittemore, R. et al. Health Technology-Enabled Interventions for Adherence Support and Retention in Care Among US HIV-Infected Adolescents and Young Adults: An Integrative Review. AIDS Behav 21, 3154–3171 (2017). https://doi.org/10.1007/s10461-017-1867-6

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