Counseling for improving adherence to antiretroviral treatment: a systematic review

ABSTRACT

One-on-one counseling can be an effective strategy to improve patient adherence to HIV treatment. The aim of this systematic review is to examine articles with one-on-one counseling-based interventions, review their components and effectiveness in improving ART adherence. A systematic review, using the following criteria was performed: (i) experimental studies; (ii) published in Spanish, English or Portuguese; (iii) with interventions consisting primarily of counseling; (iv) adherence as the main outcome; (v) published between 2005 and 2016; (vi) targeted 18 to 60 year old, independent of gender or sexual identity. The author reviewed bibliographic databases. Articles were analyzed according to the type of study, type of intervention, period of intervention, theoretical basis for intervention, time used in each counseling session and its outcomes. A total of 1790 records were identified. Nine studies were selected for the review, these applied different types of individual counseling interventions and were guided by different theoretical frameworks. Counseling was applied lasting between 4 to 18 months and these were supervised through three to six sessions over the study period. Individual counseling sessions lasted from 7.5 to 90 minutes (Me. 37.5). Six studies demonstrated significant improvement in treatment. Counseling is effective in improving adherence to ART, but methods vary. Face-to-face and computer counseling showed efficacy in improving the adherence, but not the telephone counseling. More evidence that can determine a basic counseling model without losing the individualized intervention for people with HIV is required.

KEYWORDS:

• Counseling
• adherence
• antiretroviral therapy

Acknowledgements

Research reported in this publication was supported by the Fogarty International Center of the National Institutes of Health under Award Number D43TW009763 (PARACAS-Program for Advanced Research Capacities for HIV/AIDS in Peru. The HIV Research Unit at the Institute of Tropical is partially funded by the CARIBBEAN, CENTRAL AND SOUTH AMERICA NETWORK FOR HIV EPIDEMIOLOGY (CCASANET) 5U01AI069923-14. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Yesenia Musayón-Oblitas http://orcid.org/0000-0002-0895-4605

Cesar Cárcamo http://orcid.org/0000-0001-7667-8545

Sarah Gimbel http://orcid.org/0000-0003-3330-1208

Additional information

Funding

This work was supported by Fogarty International Center of the National Institutes of Health [grant number D43 TW009763].