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Psychosocial Interventions to Promote Undetectable HIV Viral Loads: A Systematic Review of Randomized Clinical Trials

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Abstract

Suppressing HIV viral loads to undetectable levels is essential for ending the HIV/AIDS epidemic. We evaluated randomized controlled trials aimed to increase antiretroviral medication adherence and promote undetectable viral loads among people living with HIV through November 22, 2019. We extracted data from 51 eligible interventions and analyzed the results using random effects models to compare intervention effects between groups within each intervention and across interventions. We also evaluated the relation between publication date and treatment effects. Only five interventions increased undetectable viral loads significantly. As a whole, the analyzed interventions were superior to Standard of Care in promoting undetectable viral loads. Interventions published more recently were not more effective in promoting undetectable viral loads. No treatment category consistently produced significant increases in undetectable viral loads. To end the HIV/AIDS epidemic, we should use interventions that can suppress HIV viral loads to undetectable levels.

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Data Availability

Additional data are reported in Supplementary Materials. Data from any portion of the study can be obtained by contacting the corresponding author.

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Acknowledgements

The study was supported by the National Institute on Allergy and Infectious Diseases and the National Institute on Drug Abuse of the National Institutes of Health under Grants R01AI117065 and T32DA07209. The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health.

Funding

The study was supported by the National Institute on Allergy and Infectious Diseases and the National Institute on Drug Abuse of the National Institutes of Health under Grants R01AI117065 and T32DA07209. The content is solely the responsibility of the authors and does not represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Forrest Toegel, Andrew M. Rodewald, Matthew D. Novak, Sarah Pollock, Meghan Arellano, Jeannie-Marie Leoutsakos, August F. Holtyn & Kenneth Silverman

  2. Department of Psychological Science, Northern Michigan University, Marquette, MI, USA

    Forrest Toegel

  3. Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, 5200 Eastern Avenue, Suite 350 East, Baltimore, MD, 21224, USA

    Kenneth Silverman

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  1. Forrest Toegel
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Contributions

FT: Conceptualization, data curation, formal analysis, investigation, methodology, writing—original draft. AR: Investigation, methodology. MN: Investigation, writing—review & editing. SP: Investigation. MA: Investigation. JL: Formal analysis. AH: Supervision, writing—review & editing. KS: Conceptualization, methodology, investigation, supervision, writing—review & editing.

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Correspondence to Kenneth Silverman.

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Toegel, F., Rodewald, A.M., Novak, M.D. et al. Psychosocial Interventions to Promote Undetectable HIV Viral Loads: A Systematic Review of Randomized Clinical Trials. AIDS Behav 26, 1853–1862 (2022). https://doi.org/10.1007/s10461-021-03534-z

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