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The Association Between HIV Diagnosis Disclosure and Adherence to Anti-retroviral Therapy among Adolescents Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

Merid Mengesha, Melkamu LU orcid ; Teshome, Awugchew ; Ajema, Dessalegn ; Kenay Tura, Abera ; Kristensson Hallström, Inger LU and Jerene, Degu LU (2023) In PLoS ONE 18(5).
Abstract
Introduction
Nine in ten of the world’s 1.74 million adolescents living with human immunodeficiency virus (ALHIV) live in Sub-Saharan Africa. Suboptimal adherence to antiretroviral therapy (ART) and poor viral suppression are important problems among adolescents. To guide intervention efforts in this regard, this review presented pooled estimates on the prevalence of adherence and how it is affected by disclosure of HIV status among ALHIV in Sub-Saharan Africa.
Methods
A comprehensive search in major databases (Excerpta Medica database (EMBASE), PubMed, Ovid/MEDLINE, HINARI, and Google Scholar) with additional hand searches for grey literature was conducted to locate observational epidemiologic studies published in English up... (More)
Introduction
Nine in ten of the world’s 1.74 million adolescents living with human immunodeficiency virus (ALHIV) live in Sub-Saharan Africa. Suboptimal adherence to antiretroviral therapy (ART) and poor viral suppression are important problems among adolescents. To guide intervention efforts in this regard, this review presented pooled estimates on the prevalence of adherence and how it is affected by disclosure of HIV status among ALHIV in Sub-Saharan Africa.
Methods
A comprehensive search in major databases (Excerpta Medica database (EMBASE), PubMed, Ovid/MEDLINE, HINARI, and Google Scholar) with additional hand searches for grey literature was conducted to locate observational epidemiologic studies published in English up to November 12, 2022 with the following inclusion criteria: primary studies that reported disclosure of HIV status as an exposure variable, had positive adherence to ART as an outcome, and conducted among adolescents and children. The COVIDENCE software was used for a title/abstract screening, full-text screening, the JBI quality assessment checklist, and data extraction. Random effects model was used to pool estimates. Furthermore, sensitivity analysis and subgroup analysis were also conducted by age groups and type of adherence measures used.
Results
This meta-analysis combines the effect estimates from 12 primary studies with 4422 participants. The prevalence of good adherence to ART was 73% (95% CI (confidence interval): 56 to 87; I2 = 98.63%, P = Conclusions
Our meta-analysis and systematic review revealed that knowledge of one’s HIV status was associated with adherence to ART, particularly among adolescents. The findings underscored the importance of encouraging disclosure in order to enhance adherence among adolescents. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
18
issue
5
article number
e0285571
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:37167342
  • scopus:85159555951
ISSN
1932-6203
DOI
10.1371/journal.pone.0285571
project
Feasibility and effectiveness of peer-support based digital anti-stigma interventions in improving clinical outcomes among adolescents living with HIV in Ethiopia
Improving adherence to antiretroviral therapy among adolescents living with HIV in Ethiopia
eHealth as an aid for facilitating and supporting self-management in families with long-term childhood illness – development, evaluation and implementation in clinical practice
language
English
LU publication?
yes
id
f5df4ef7-c629-457b-b7dc-a444150a8f72
date added to LUP
2023-04-28 10:04:42
date last changed
2024-05-16 09:23:05
@article{f5df4ef7-c629-457b-b7dc-a444150a8f72,
  abstract     = {{Introduction<br/>Nine in ten of the world’s 1.74 million adolescents living with human immunodeficiency virus (ALHIV) live in Sub-Saharan Africa. Suboptimal adherence to antiretroviral therapy (ART) and poor viral suppression are important problems among adolescents. To guide intervention efforts in this regard, this review presented pooled estimates on the prevalence of adherence and how it is affected by disclosure of HIV status among ALHIV in Sub-Saharan Africa.<br/>Methods<br/>A comprehensive search in major databases (Excerpta Medica database (EMBASE), PubMed, Ovid/MEDLINE, HINARI, and Google Scholar) with additional hand searches for grey literature was conducted to locate observational epidemiologic studies published in English up to November 12, 2022 with the following inclusion criteria: primary studies that reported disclosure of HIV status as an exposure variable, had positive adherence to ART as an outcome, and conducted among adolescents and children. The COVIDENCE software was used for a title/abstract screening, full-text screening, the JBI quality assessment checklist, and data extraction. Random effects model was used to pool estimates. Furthermore, sensitivity analysis and subgroup analysis were also conducted by age groups and type of adherence measures used.<br/>Results<br/>This meta-analysis combines the effect estimates from 12 primary studies with 4422 participants. The prevalence of good adherence to ART was 73% (95% CI (confidence interval): 56 to 87; I2 = 98.63%, P = Conclusions<br/>Our meta-analysis and systematic review revealed that knowledge of one’s HIV status was associated with adherence to ART, particularly among adolescents. The findings underscored the importance of encouraging disclosure in order to enhance adherence among adolescents.}},
  author       = {{Merid Mengesha, Melkamu and Teshome, Awugchew and Ajema, Dessalegn and Kenay Tura, Abera and Kristensson Hallström, Inger and Jerene, Degu}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{5}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{The Association Between HIV Diagnosis Disclosure and Adherence to Anti-retroviral Therapy among Adolescents Living with HIV in Sub-Saharan Africa: A Systematic Review and Meta-Analysis}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0285571}},
  doi          = {{10.1371/journal.pone.0285571}},
  volume       = {{18}},
  year         = {{2023}},
}