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Translational Behavioral Medicine

, Volume 5, Issue 3, pp 294–306 | Cite as

Computer-based HIV adherence promotion interventions: a systematic review

Translation Behavioral Medicine
  • Kasey R. ClabornEmail author
  • Anne Fernandez
  • Tyler Wray
  • Susan Ramsey
Systematic Reviews

Abstract

Researchers have instituted a range of methodologies to increase access to HIV adherence interventions. This article reviews studies published through January 2014 utilizing computer-based delivery of such interventions to persons living with HIV. A systematic review of five databases identified ten studies (three RCTs, three pilot studies, three feasibility studies, and one single-group trial) that met the inclusion criteria. Descriptions of the interventions’ content and characteristics are included. Interventions varied widely in terms of program structure, theoretical framework, and content. Only six studies reported medication adherence outcomes. Of these, four (five RCTS and one single group pre-post test) reported significant improvement in adherence using various measures, and two approached significance. Results suggest that computer-delivered adherence interventions are feasible and acceptable among both HIV-positive adolescents and adults. Definitive conclusions regarding clinical impact cannot be drawn due to the small number of adequately powered randomized trials in this review. Additional randomized controlled research is needed to draw inferences regarding intervention efficacy.

Keywords

Computer-based intervention HIV Adherence eHealth 

Notes

Acknowledgments

This was an investigator-initiated study supported in part by grant number T32 AA007459 from the National Institute on Alcohol Abuse and Alcoholism at the National Institutes of Health. The funders played no role in the design, conduct or analysis of the study, nor in the interpretation and reporting of the study findings. All authors had full access to all of the data in the study (including statistical reports and tables) and can take responsibility for the integrity of the data and the accuracy of the data analysis.

Conflict of Interest

Kasey Claborn, Anne Fernandez, Tyler Wray, and Susan Ramsey declare that they have no conflict of interest.

References

  1. 1.
    CDC. Monitoring selected national HIV prevention and care objectives by using HIV surveillance data-United States and 6 U.S. dependent areas-2010. HIV Surveillance Supplemental Report 2012.Google Scholar
  2. 2.
    Hall H, Frazier E, Skarbinski J, et al. Differences in human immunodeficiency virus care and treatment among subpopulations in the United States. JAMA Internal Medicine. 2013; 173(14): 1337-1344.CrossRefPubMedGoogle Scholar
  3. 3.
    Ortego C, Huedo-Medina T, Vejo J, et al. Adherence to highly active antiretroviral therapy (HAART): a meta-analysis. AIDS and Behavior. 2011; 15(7): 1381-1396.CrossRefPubMedGoogle Scholar
  4. 4.
    Paterson D, Swindells S, Singh N, et al. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Annals of Internal Medicine. 2000; 133(1): 21-30.CrossRefPubMedGoogle Scholar
  5. 5.
    Bangsberg D, Perry S, Moss A, et al. Non-adherence to highly active antiretroviral therapy predicts progression to AIDS. AIDS (London, England). 2001; 15(9): 1181-1183.CrossRefGoogle Scholar
  6. 6.
    Lima V, Harrigan R, Montaner J, et al. The combined effect of modern highly active antiretroviral therapy regimens and adherence on mortality over time. Journal of Acquired Immune Deficiency Syndromes. 2009; 50(5): 529-536.PubMedCentralCrossRefPubMedGoogle Scholar
  7. 7.
    Sethi A, Celentano D, Gange S, Moore R, Gallant J. Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 2003; 37(8): 1112-1118.CrossRefGoogle Scholar
  8. 8.
    Cohen M, Chen Y, Fleming T, et al. Prevention of HIV-1 infection with early antiretroviral therapy. The New England Journal of Medicine. 2011; 365(6): 493-505.PubMedCentralCrossRefPubMedGoogle Scholar
  9. 9.
    Simoni J, Pearson C, Pantalone D, Marks G, Crepaz N. Efficacy of interventions in improving highly active antiretroviral therapy adherence and HIV-1 RNA viral load: a meta-analytic review of randomized controlled trials. Journal of Acquired Immune Deficiency Syndromes. 2006; 43(Suppl1): S23-S35.PubMedCentralCrossRefPubMedGoogle Scholar
  10. 10.
    Simoni J, Amico K, Smith L, Nelson K. Antiretroviral adherence interventions: translating research findings to the real world clinic. Current HIV/AIDS Reports. 2010; 7(1): 44-51.PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    Chen H, Grimley D, Waithaka Y, Aban I, Hu J, Bachmann L. A process evaluation of the implementation of a computer-based, health provider-delivered HIV-prevention intervention for HIV-positive men who have sex with men in the primary care setting. AIDS Care. 2008; 20(1): 51-60.CrossRefPubMedGoogle Scholar
  12. 12.
    Goldstein M, Guise B, Ruggiero L, Raciti M, Abrams D. Behavioral medicine strategies for medical patients. In: Clinical psychiatry for medical students [e-book]. Philadelphia: J B Lippincott Company; 1990: 609-629.Google Scholar
  13. 13.
    Whitlock E, Orleans C, Pender N, Allan J. Evaluating primary care behavioral counseling interventions: an evidence-based approach. American Journal of Preventive Medicine. 2002; 22(4): 267-284.CrossRefPubMedGoogle Scholar
  14. 14.
    Dewing S, Mathews C, Schaay N, Cloete A, Louw J, Simbayi L. Behaviour change counselling for ARV adherence support within primary health care facilities in the Western Cape, South Africa. AIDS and Behavior. 2012; 16(5): 1286-1294.CrossRefPubMedGoogle Scholar
  15. 15.
    Mepham S, Zondi Z, Mbuyazi A, Mkhwanazi N, Newell M. Challenges in PMTCT antiretroviral adherence in northern KwaZulu-Natal, South Africa. AIDS Care. 2011; 23(6): 741-747.CrossRefPubMedGoogle Scholar
  16. 16.
    Grant E, Logie D, Masura M, Gorman D, Murray S. Factors facilitating and challenging access and adherence to antiretroviral therapy in a township in the Zambian Copperbelt: a qualitative study. AIDS Care. 2008; 20(10): 1155-1160.CrossRefPubMedGoogle Scholar
  17. 17.
    Murray L, Semrau K, Bolton P, et al. Barriers to acceptance and adherence of antiretroviral therapy in urban Zambian women: a qualitative study. AIDS Care. 2009; 21(1): 78-86.PubMedCentralCrossRefPubMedGoogle Scholar
  18. 18.
    Rotheram-Borus M, Swendeman D, Chovnick G. The past, present, and future of HIV prevention: integrating behavioral, biomedical, and structural intervention strategies for the next generation of HIV prevention. Annual Review of Clinical Psychology [serial online]. 2009; 5: 143-167.CrossRefGoogle Scholar
  19. 19.
    Swendeman D, Rotheram-Borus M. Innovation in sexually transmitted disease and HIV prevention: internet and mobile phone delivery vehicles for global diffusion. Current Opinion in Psychiatry. 2010; 23(2): 139-144.PubMedCentralCrossRefPubMedGoogle Scholar
  20. 20.
    Pellowski J, Kalichman S. Recent advances (2011–2012) in technology-delivered interventions for people living with HIV. Current HIV/AIDS Reports. 2012; 9(4): 326-334.PubMedCentralCrossRefPubMedGoogle Scholar
  21. 21.
    Mohr DC, Burns M, Schueller SM, Clarke G, Klinkman M. Behavioral intervention technologies: evidence review and recommendations for future research in mental health. General Hospital Psychiatry. 2013; 35(4): 332-338.PubMedCentralCrossRefPubMedGoogle Scholar
  22. 22.
    The Pew Charitable Trust. Mobile Technology Fact Sheet. 2014. Available from: http://www.pewinternet.org/fact-sheets/mobile-technology-fact-sheet/
  23. 23.
    Chiasson M, Hirshfield S, Rietmeijer C. HIV prevention and care in the digital age. Journal of Acquired Immune Deficiency Syndromes. 2010; 55(Suppl 2): S94-S97.CrossRefPubMedGoogle Scholar
  24. 24.
    Catalani C, Philbrick W, Fraser H, Mechael P, Israelski D. mHealth for HIV treatment & prevention: a systematic review of the literature. The Open AIDS Journal. 2013; 7: 17-41.PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Van Volkom M, Stapley J, Amaturo V. Revisiting the digital divide: generational differences in technology use in everyday life. North American Journal of Psychology. 2014; 16(3): 557-574.Google Scholar
  26. 26.
    Moher D, Liberati A, Tetzlaff J, Altman D. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. International Journal of Surgery (London, England). 2010; 8(5): 336-341.CrossRefGoogle Scholar
  27. 27.
    Claborn K, Leffingwell T, Miller M, Meier E, Stephens J. Pilot study examining the efficacy of an electronic intervention to promote HIV medication adherence. AIDS Care. 2014; 26(3): 404-409.CrossRefPubMedGoogle Scholar
  28. 28.
    Côté J, Godin G, Fadel G, et al. Evaluation of a real-time virtual intervention to empower persons living with HIV to use therapy self-management: study protocol for an online randomized controlled trial. Trials. 2012; 13: 187.PubMedCentralCrossRefPubMedGoogle Scholar
  29. 29.
    Fisher J, Amico K, Friedland G, et al. Computer-based intervention in HIV clinical care setting improves antiretroviral adherence: the LifeWindows Project. AIDS and Behavior. 2011; 15(8): 1635-1646.CrossRefPubMedGoogle Scholar
  30. 30.
    Hersch R, Cook R, Spencer J, et al. Test of a web-based program to improve adherence to HIV medications. AIDS and Behavior. 2013; 17(9): 2963-2976.CrossRefPubMedGoogle Scholar
  31. 31.
    Horvath K, Oakes J, Simoni J, et al. Feasibility, acceptability and preliminary efficacy of an online peer-to-peer social support ART adherence intervention. AIDS and Behavior. 2013; 17(6): 2031-2044.PubMedCentralCrossRefPubMedGoogle Scholar
  32. 32.
    Naar-King S, Outlaw A, Ondersma S, et al. Motivational Enhancement System for Adherence (MESA): pilot randomized trial of a brief computer-delivered prevention intervention for youth initiating antiretroviral treatment. Journal of Pediatric Psychology. 2013; 38(6): 638-648.PubMedCentralCrossRefPubMedGoogle Scholar
  33. 33.
    Ownby R, Waldrop-Valverde D, Caballero J, Jacobs R. Baseline medication adherence and response to an electronically delivered health literacy intervention targeting adherence. Neurobehavioral HIV Medicine. 2012; 4: 113-121.PubMedCentralCrossRefPubMedGoogle Scholar
  34. 34.
    Remien R, Mellins C, Stein D, et al. Masivukeni: development of a multimedia based antiretroviral therapy adherence intervention for counselors and patients in South Africa. AIDS and Behavior. 2013; 17(6): 1979-1991.PubMedCentralCrossRefPubMedGoogle Scholar
  35. 35.
    Shegog R, Markham C, Leonard A, Bui T, Paul M. ' + CLICK': pilot of a web-based training program to enhance ART adherence among HIV-positive youth. AIDS Care. 2012; 24(3): 310-318.CrossRefPubMedGoogle Scholar
  36. 36.
    Higgins J, Altman D, Sterne J, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ (Clinical Research Ed). 2011; 343: d5928.CrossRefGoogle Scholar
  37. 37.
    Outlaw A, Naar-King S, Merlo L, et al. The initial feasibility of a computer-based motivational intervention for adherence for youth newly recommended to start antiretroviral treatment. AIDS Care. 2014; 26(1): 130-135.CrossRefPubMedGoogle Scholar
  38. 38.
    Pop-Eleches C, Thirumurthy H, Bangsberg D, et al. Mobile phone technologies improve adherence to antiretroviral treatment in a resource-limited setting: a randomized controlled trial of text message reminders. Aids. 2011; 25(6): 825-834.PubMedCentralCrossRefPubMedGoogle Scholar
  39. 39.
    Safren S, Otto M, Worth J. Life-steps: applying cognitive behavioral therapy to HIV medication adherence. Cognitive and Behavioral Practice [serial online]. Fal 1999 1999;6(4):332–341.Google Scholar
  40. 40.
    Cole-Lewis H, Kershaw T. Text messaging as a tool for behavior change in disease prevention and management. Epidemiologic Reviews. 2010; 32(1): 56-69.PubMedCentralCrossRefPubMedGoogle Scholar
  41. 41.
    Thirumurthy H, Lester RT. M-health for health behaviour change in resource-limited settings: applications to HIV care and beyond. Bulletin of the World Health Organization. 2012; 90(5): 390-392.PubMedCentralCrossRefPubMedGoogle Scholar
  42. 42.
    Faulkner C, Fidler F, Cumming G. The value of RCT evidence depends on the quality of statistical analysis. Behaviour Research and Therapy. 2008; 46(2): 270-281.CrossRefPubMedGoogle Scholar

Copyright information

© Society of Behavioral Medicine 2015

Authors and Affiliations

  • Kasey R. Claborn
    • 1
    • 3
    Email author
  • Anne Fernandez
    • 1
  • Tyler Wray
    • 1
  • Susan Ramsey
    • 2
  1. 1.Center for Alcohol and Addiction Studies and the Alcohol Research Center on HIVBrown UniversityProvidenceUSA
  2. 2.Brown University School of Medicine and Rhode Island HospitalProvidenceUSA
  3. 3.ProvidenceUSA

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