Skip to main content

Advertisement

SpringerLink
Log in

Peer-led Self-management Interventions and Adherence to Antiretroviral Therapy Among People Living with HIV: A Systematic Review

  • Substantive Review
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

Adherence to antiretroviral therapy (ART) is essential to reduce morbidity and mortality among people living with HIV (PLWH). However, adherence remains suboptimal, and PLWH may benefit from more self-management support to address the complexities of chronic illness. Our objective was to identify the impact of peer-led self-management interventions on adherence and patient-reported outcomes (PROs) among PLWH. We searched MEDLINE, PubMed, Embase, PsycINFO, and CINAHL for English language publications from 1996 to March 2018, and included controlled intervention studies. Additional articles were handsearched, risk of bias assessed, and narrative syntheses outlined. Thirteen studies met inclusion criteria. Findings demonstrate unclear effectiveness for peer-led self-management interventions improving ART adherence; however evidence was limited with only seven studies measuring this outcome and some risk of bias. Many PROs were measured, with limited consistent findings. Future research is needed to strengthen the evidence regarding effects of peer-led self-management interventions on adherence and PROs among PLWH.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

HIV:

Human immunodeficiency virus

PLWH:

People living with HIV

ART:

Antiretroviral therapy

PRO:

Patient-reported outcome

RCT:

Randomized controlled trial

MSM:

Men who have sex with men

EDM:

Electronic drug monitors

References

  1. Siddiqi A-A, Hall HI, Hu X, Song R. Population-based estimates of life expectancy after HIV diagnosis. United States 2008–2011. J AIDS. 2016;72(1):230–6.

    Google Scholar 

  2. Mills EJ, Nachega JB, Bangsberg DR, Singh S, Rachlis B, Wu P, et al. Adherence to HAART: a systematic review of developed and developing nation patient-reported barriers and facilitators. PLoS Med. 2006;3(11):e438.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Crepaz N, Dong X, Wang X, Hernandez A, Hall H. Racial and ethnic disparities in sustained viral suppression and transmission risk potential among persons receiving HIV care—United States, 2014. Morb Mortal Wkly Rep. 2018;67(4):113–8.

    Article  Google Scholar 

  4. Elzarrad MK, Eckstein ET, Glasgow RE. Applying chronic illness care, implementation science, and self-management support to HIV. Am J Prev Med. 2013;44(1):S99–107.

    Article  PubMed  Google Scholar 

  5. Cohen MS, Chen YQ, McCauley M, Gamble T, Hosseinipour MC, Kumarasamy N, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365(6):493–505.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Werb D, Mills EJ, Montaner JS, Wood E. Risk of resistance to highly active antiretroviral therapy among HIV-positive injecting drug users: a meta-analysis. Lancet Infect Dis. 2010;10:464–9.

    Article  PubMed  Google Scholar 

  7. Drescher S, von Wyl V, Yang WL, Boni J, Yerly S, Shah C, et al. Treatment-naive individuals are the major source of transmitted HIV-1 drug resistance in men who have sex with men in the swiss HIV cohort study. Clin Infect. 2014;58(2):285–94.

    Article  CAS  Google Scholar 

  8. Rueda S, Park-Wyllie LY, Bayoumi AM, Tynan AM, Antoniou TA, Rourke SB, et al. Patient support and education for promoting adherence to highly active antiretroviral therapy for HIV/AIDS. Cochrane Database Syst Rev. 2006;3:CD001442.

    Google Scholar 

  9. Adams K, Greiner AC, Corrigan JM. The 1st annual crossing the quality chasm summit. Washington, DC: The National Academies Press; 2004. p. 159.

    Google Scholar 

  10. Barr VJ, Robinson S, Marin-Link B, Underhill L, Dotts A, Ravensdale D, et al. The expanded chronic care model: an integration of concepts and strategies from population health promotion and the chronic care model. Hosp Q. 2003;2003(7):73–82.

    Google Scholar 

  11. Liddy C, Blazkho V, Mill K. Challenges of self-management when living with multiple chronic conditions systematic review of the qualitative literature. Can Fam Phys. 2014;60:1123–33.

    Google Scholar 

  12. Lorig KR, Holman HR. Self-management education: history, definition, outcomes, and mechanisms. Ann Behav Med. 2003;26(1):1–7.

    Article  PubMed  Google Scholar 

  13. Lorig K. Partnerships between expert patients and physicians. Lancet. 2002;359:814–5.

    Article  PubMed  Google Scholar 

  14. Swendeman D, Ingram BL, Rotheram-Borus MJ. Common elements in self-management of HIV and other chronic illnesses: an integrative framework. AIDS Care. 2009;21(10):1321–34.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Millard T, Elliott J, Girdler S. Self-management education programs for people living with HIV/AIDS: a systematic review. AIDS Patient Care STDS. 2013;27(2):103–13.

    Article  PubMed  Google Scholar 

  16. Bernardin KN, Toews DN, Restall GJ, Vuongphan L. Self-management interventions for people living with human immunodeficiency virus: a scoping review. Can J Occup Ther. 2013;80(5):314–27.

    Article  PubMed  Google Scholar 

  17. Nkhoma K, Norton C, Sabin C, Winston A, Merlin J, Harding R. Self-management interventions for pain and physical symptoms among people living with HIV: a systematic review of the evidence. JAIDS. 2018;79(2):206–25.

    PubMed  Google Scholar 

  18. Ontario HIV Treatment Network (OHTN). Priority populations [Internet]. http://www.ohtn.on.ca/research-portals/priority-populations/. Accessed 21 Mar 2019.

  19. CATIE (Canadian AIDS Treatment Information Exchange). Practice guidelines in peer health navigation for people living with HIV. [Internet]. 2018. https://www.catie.ca/ga-pdf.php?file=sites/default/files/practice-guidelines-peer-nav-en-02082018.pdf. Accessed 21 Feb 2018.

  20. O’Brien N, Greene S, Carter A, Lewis J, Nicholson V, Kwaramba G, et al. Envisioning women-centered HIV care: perspectives from women living with HIV in Canada. Womens Health Issues. 2017;27(6):721–30.

    Article  PubMed  Google Scholar 

  21. Cooper V, Clatworthy J, Whetham J, Consortium E. mHealth interventions to support self-management in HIV: a systematic review. Open AIDS J. 2017;11:119–32.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ory M, Ahn S, Jiang L, Smith M. Successes of a national study of the chronic disease self-management program: meeting the triple aim of health care reform. Med Care. 2013;51:992–8.

    Article  PubMed  Google Scholar 

  23. Embuldeniya G, Veinot P, Bell E, Bell M, Nyhof-Young J, Sale JEM, et al. The experience and impact of chronic disease peer support interventions: a qualitative synthesis. Patient Educ Couns. 2013;92(1):3–12.

    Article  PubMed  Google Scholar 

  24. Genberg BL, Shangani S, Sabatino K, Rachlis B, Wachira J, Braitstein P, et al. Improving engagement in the HIV care cascade: a systematic review of interventions involving people living with HIV/AIDS as peers. AIDS Behav. 2016;20:2452–63.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Kanters S, Park JJ, Chan K, Ford N, Forrest J, Thorlund K, et al. Use of peers to improve adherence to antiretroviral therapy: a global network meta-analysis. J Int AIDS Soc. 2016;19:21141.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Logie CH, James L, Tharao W, Loutfy MR. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada. PLoS Med. 2011;8(11):e1001124.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Canadian Institutes of Health Research. CIHR HIV/AIDS Research Initiative: Strategic Plan 2015-2020 [Internet]. Ottawa, ON; 2015. http://www.cihr-irsc.gc.ca/e/documents/hiv_strat_plan_2015-20_en.pdf. Accessed 5 Mar 2018.

  28. Ontario Advisory Committee on HIV/AIDS. HIV/AIDS strategy to 2026: Focusing our efforts – changing the course of the HIV prevention, engagement and care cascade in Ontario [Internet]. Toronto, ON; 2016. http://www.health.gov.on.ca/en/pro/programs/hivaids/oach_strategy.aspx. Accessed 7 Oct 2019.

  29. Goodin BR, Owens MA, White DM, Strath LJ, Rainey RL, Okunbor JI, et al. Intersectional health-related stigma in persons living with HIV and chronic pain: implications for depressive symptoms. AIDS Care. 2018;30(Suppl2):66–73.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Higgins J, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration; 2011.

  31. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Kelly E, Ivers N, Zawi R, Barnieh L, Manns B, Lorenzetti DL, et al. Patient navigators for people with chronic disease: protocol for a systematic review and meta-analysis. Syst Rev. 2015;4:28.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Kessler D, Liddy C. Self-management support programs for persons with Parkinson’s disease: an integrative review. Patient Educ Couns. 2017;100:1787–95.

    Article  PubMed  Google Scholar 

  34. U.S. Department of Health and Human Services Food and Drug Administration. Guidance for Industry Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims [Internet]. 2009. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/patient-reported-outcome-measures-use-medical-product-development-support-labeling-claims. Accessed 7 Oct 2019.

  35. Engler K, Lessard D, Lebouché B. A review of HIV-specific patient-reported outcome measures. Patient. 2017;10(2):187–202.

    Article  PubMed  Google Scholar 

  36. Bandura A. Social learning theory. New Jersey: Prentice Hall; 1977.

    Google Scholar 

  37. Bandura A. Social Foundations of Thought and Action. New Jersey: Prentice Hall; 1986.

    Google Scholar 

  38. Clarivate analytics—EndNote [Internet]. https://endnote.com/. Accessed 10 Mar 2018.

  39. Evidence Partners—Distiller SR [Internet]. https://www.evidencepartners.com/. Accessed 22 Mar 2018.

  40. Wang S, Moss JR, Hiller JE. Applicability and transferability of interventions in evidence-based public health. Health Promot Int. 2006;21(1):76–83.

    Article  PubMed  Google Scholar 

  41. Higgins JPT, Green S, Cochrane Collaboration. Assessing risk of bias in included studies. In: Higgins JPT, Altman DG, editors. Cochrane handbook for systematic reviews of interventions. Chichester: The Cochrane Collaboration and John Wiley & Sons Ltd; 2008. p. 187–241.

    Chapter  Google Scholar 

  42. Brashers DE, Basinger ED, Rintamaki LS, Caughlin JP, Para M. Taking control: the efficacy and durability of a peer-led uncertainty management intervention for people recently diagnosed with HIV uncertainty and living with HIV. Health Commun. 2017;32(1):11–21.

    Article  PubMed  Google Scholar 

  43. Enriquez M, Cheng AL, Banderas J, Farnan R, Chertoff K, Hayes D, et al. A peer-led hiv medication adherence intervention targeting adults linked to medical care but without a suppressed viral load. J Int Assoc Provid AIDS Care. 2015;14(5):441–8.

    Article  PubMed  Google Scholar 

  44. Giordano TP, Cully J, Amico KR, Davila JA, Kallen MA, Hartman C, et al. A randomized trial to test a peer mentor intervention to improve outcomes in persons hospitalized with HIV infection. Clin Infect Dis. 2016;63(5):678–86.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Merlin JS, Westfall AO, Long D, Davies S, Saag M, Demonte W, et al. A randomized pilot trial of a novel behavioral intervention for chronic pain tailored to individuals with HIV. AIDS Behav. 2018;22(8):2733–42.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Purcell DW, Latka MH, Metsch LR, Latkin CA, Gómez CA, Mizuno Y, et al. Results from a randomized controlled trial of a peer-mentoring intervention to reduce HIV transmission and increase access to care and adherence to HIV medications among HIV-seropositive injection drug users. J Aquir Immune Defic Syndr. 2007;46(S2):S35–47.

    Article  Google Scholar 

  47. Webel AR. Testing a peer-based symptom management intervention for women living with HIV/AIDS. AIDS Care. 2010;22(9):1029–40.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Wewers ME, Neidig JL, Kihm KE. The feasibility of a nurse-managed, peer-led tobacco cessation intervention among HIV-positive smokers. JANAC. 2000;11(6):37–44.

    CAS  PubMed  Google Scholar 

  49. Wolitski RJ, Gó Mez CA, Parsons JT. Effects of a peer-led behavioral intervention to reduce HIV transmission and promote serostatus disclosure among HIV-seropositive gay and bisexual men. AIDS. 2005;19(S1):S99–109.

    Article  PubMed  Google Scholar 

  50. Simoni JM, Huh D, Frick PA, Pearson CR, Andrasik MP, Dunbar PJ, et al. Peer support and pager messaging to promote antiretroviral modifying therapy in seattle: a randomized controlled trial. J Acquir Immune Defic Syndr. 2009;52(4):465–73.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Simoni JM, Pantalone DW, Plummer MD, Huang B. A randomized controlled trial of a peer support intervention targeting antiretroviral medication adherence and depressive symptomatology in HIV-positive men and women. Heal Psychol. 2007;26(4):488–95.

    Article  Google Scholar 

  52. Millard T, Agius PA, McDonald K, Slavin S, Girdler S, Elliott JH. The positive outlook study: a randomised controlled trial evaluating online self-management for HIV positive gay men. AIDS Behav. 2016;20:1907–18.

    Article  PubMed  Google Scholar 

  53. Parker R, Jelsma J, Stein DJ. Managing pain in women living with HIV/AIDS: a randomized controlled trial testing the effect of a six-week peer-led exercise and education intervention. J Nerv Ment Dis. 2016;204(9):665–72.

    Article  PubMed  Google Scholar 

  54. Ruiz I, Olry A, López MÁ, Prada JL, Causse M. Prospective, randomized, two-arm controlled study to evaluate two interventions to improve adherence to antiretroviral therapy in Spain. Enferm Infecc Microbiol Clin. 2010;28(7):409–15.

    Article  PubMed  Google Scholar 

  55. Wantland DJ, Holzemer WL, Moezzi S, Willard SS, Arudo J, Kirksey KM, et al. A randomized controlled trial testing the efficacy of an HIV/AIDS symptom management manual. J. Pain Symptom Manag. 2008;36(3):235–46.

    Article  Google Scholar 

  56. Mishel MH. The measurement of uncertainty in illness. Nurs. Res. 1981;30(5):258–63. https://doi.org/10.1097/00006199-198109000-00002.

    Article  CAS  PubMed  Google Scholar 

  57. High-resolution Risk of Bias assessment graph… in Excel! [Internet]. http://www.robinkok.eu/2016/03/11/risk-of-bias-assessment-graph-in-excel/. Accessed 19 Apr 2019.

  58. Packer T, Fracini A, Audulv A, Alizadeh N, van Gaal B, Warner G, et al. What we know about their purpose, theoretical foundation, scope and dimensionality of existing self-management measurement tools: a scoping review. Patient Educ Couns. 2017;101(4):579–95.

    Article  PubMed  Google Scholar 

  59. Nicholas PK, Thompson C, Moezzi S, Stanton MA, Human SP, Nokes KM, et al. Engagement with care, substance use, and adherence to therapy in HIV/AIDS. AIDS Res Treat. 2014. https://doi.org/10.1155/2014/675739.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Sokol R, Fisher E. Peer support for the hardly reached: a systematic review. Am J Public Health. 2016;106:e1–8.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ. 2014;348:g1687.

    Article  PubMed  Google Scholar 

  62. Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new medical research council guidance. Int J Nurs Stud. 2013;50:585–92.

    Article  PubMed  Google Scholar 

  63. Scott-Sheldon LAJ, Balletto BL, Donahue ML, Feulner MM, Cruess DG, Salmoirago-Blotcher E, et al. Mindfulness-based interventions for adults living with HIV/AIDS: a systematic review and meta-analysis. AIDS Behav. 2018;23(1):60–75.

    Article  Google Scholar 

  64. Bhatta DN, Liabsuetrakul T, McNeil EB. Social and behavioral interventions for improving quality of life of HIV infected people receiving antiretroviral therapy: a systematic review and meta-analysis. Health Qual. Life Outcomes. 2017;15:80.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors are grateful to Lindsey Sikora, Health Sciences Research Liaison Librarian, for providing peer review of the MEDLINE search strategy. The authors also thank Janessa Porter, Research Assistant, for help with piloting the abstract screening. LB is funded by a Canadian Institutes of Health Research (CIHR) Doctoral Research Award: Priority Announcement—HIV/AIDS and conducted this review as part of course requirements in the Epidemiology and Public Health doctoral program at the University of Ottawa. CK holds a CIHR-Ontario HIV Treatment Network New Investigator Award. CL is supported by a Tier 2 Chair in Family Medicine at the University of Ottawa.

Author information

Authors and Affiliations

  1. School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada

    Lisa M. Boucher

  2. C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, ON, Canada

    Lisa M. Boucher, Clare Liddy, Ariana Mihan & Claire Kendall

  3. Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada

    Clare Liddy & Claire Kendall

Authors
  1. Lisa M. Boucher
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Clare Liddy
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ariana Mihan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Claire Kendall
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

LB designed this study with methodological and clinical guidance from CL and CK. LB and AM conducted two levels of screening, data extraction and risk of bias assessment. LB drafted the manuscript including search strategy, and AM, CL and CK revised it. LB is the guarantor of the review.

Corresponding author

Correspondence to Lisa M. Boucher.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

As this article reports a review of existing studies, no informed consent was required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 15 kb)

Supplementary material 2 (DOCX 15 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Boucher, L.M., Liddy, C., Mihan, A. et al. Peer-led Self-management Interventions and Adherence to Antiretroviral Therapy Among People Living with HIV: A Systematic Review. AIDS Behav 24, 998–1022 (2020). https://doi.org/10.1007/s10461-019-02690-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-019-02690-7

Keywords

Search

Navigation