Table 1:
Characteristics of studies included in the qualitative synthesis
| Author and Year | Journal/Conference | Location | Baseline Sample Characteristics | Intervention Design | Adherence Measurement | Baseline Adherence | Methodological Quality |
|---|---|---|---|---|---|---|---|
| da Costa et al., 2012 (35) | International Journal of Medical Informatics | Sao Paulo, Brazil | 29 women; mean age: 34.6; 67% married; 52% completed secondary education | SMS-based intervention tested over 4 months, messages were tied to dose time and delivered 4 times per week vs. control that did not receive SMS messages | SR (number missed in last 30 days), pill count (%, monthly), Medication Event Monitoring System (%, MEMS) caps (monthly); 1, 2, 3, 4 months follow-up | Intervention = 75% (MEMS) Control = 61.54% |
Total Score = 18 Rating = Fair |
| Holstad et al., 2011 (51) | AIDS and Behavior | Atlanta, GA | 207 women; mean age: 43.5; 27.2% married; 80.8 % completed secondary education | Motivation interviewing group based intervention using Social Cognitive Theory to promote medication adherence and risk reduction behaviors (8 sessions) vs. a health promotion group based control (8 sessions) |
MEMS caps (%, 2 weeks), 3, 6, and 9 months follow-up | Intervention = 73.5% (SD=33.5) Control = 74.9% (SD=31.8) |
Total Score = 19 Rating = Fair |
| Holstad et al., 2012 (36) | African Journal of Reproductive Health | Lagos, Nigeria | 60 women; mean age: 30.7; 46% married; 90% completed secondary education | Motivation interviewing group based intervention using Social Cognitive Theory to promote medication adherence and risk reduction behaviors (8 sessions) vs. a health promotion group based control (8 sessions) | SR (VAS [%, 30 days], AGAS [score on scale, 30 days], ACTG [score on scale, up to 3 months ago]); 6 month follow-up | Baseline data not reported | Total Score = 20 Rating = Good |
| Jones et al., 2003 (56) | AIDS Care | Miami, New York City, and New Jersey, USA | 174 women with AIDS; mean age: 37; 48% single; 52% completed secondary education | Cognitive-behavioral stress management/expressive supportive therapy (CBSM+) group intervention (10 sessions) vs. time-matched individual based informational/educational control | SR (AMS [%, 7 days]); baseline, 10 week follow-up; * effect size could only be calculated for low adherers at baseline | * low adherers at baseline; Intervention = 46% (SD = 28.4) Control = 51% (SD=25.7) |
Total Score = 16 Rating = Fair |
| Jones et al., 2007 (57) | AIDS and Behavior | Miami, New York City, and New Jersey, USA | 177 women; mean age: 41; 53% completed secondary education | 2×2 factorial design-Phase 1: CBSM+ group vs. individual (both 10 sessions); Phase 2: Healthier Lifestyles groups vs. individual (both 6 sessions) | SR (ACTG [%, 4 days]); baseline, 3 and 6 month follow-ups *effect size any group vs. individual only | Baseline data not reported | Total Score = 16 Rating = Fair |
| Kempf et al., 2016 (38) | 11th International Conference on HIV Treatment and Prevention Adherence | Rural Alabama, USA | 22 women with depression; mean age: 45.8; 32% married; 82% completed secondary education | Cognitive Behavioral Therapy for Adherence and Depression (CBT-AD) in HIV (10 sessions) vs. time-matched supportive psychotherapy (both via telemedicine) | Wisepill [%, past week]; baseline, 3 and 6 month follow-ups | Intervention = 94.8% (SD=13.2) Control = 84.4% (SD=26.7) |
Total Scoreb = 18 Rating = Fair |
| Kiweewa et al., 2013 (42) | JAIDS: Journal of Acquired Immune Deficiency Syndromes | Kampala, Uganda | 92 women who were WHO stage III/IV or had CD4 cell counts less than 200 attending PMTCT program (pregnancy/postpartum was not an inclusion criteria for entry into the study); mean age: 27.3; 78% married; 52% completed secondary education |
Intervention delivered by nurses trained in ART management and peer counselors (7 sessions across 1 year) with home visits by peer counselors for missed appointments vs. standard clinic-based model | Pill count [%, study period]; 6-12 months after ART initiation | Baseline data not reported | Total Score = 21 Rating = Good |
| Mann 2001 (58) | Annals of Behavioral Medicine | NR | 44 women; mean age: 38.5; 23% married | Expressive future writing group (10 minutes, twice a week for 4 weeks) vs. no writing group | SR (RAND Medical Outcomes Study, [6 point Likert Scale, past month]); baseline, 1 month follow-up | Intervention = 4.54 (SD=0.28; items averaged from a 6 point Likert scale) Control = 4.93 (SD=0.22) |
Total Score = 17 Rating = Fair |
| Messersmith et al., 2017 (37) | 12th International Conference on HIV Treatment and Prevention Adherence | Mityana, Uganda | 133 pregnant women (12-28 weeks) on once day regimens; mean age: 25.4; 73% married; 94% completed secondary education | SMS reminder if Wisepill was not opened within 2 hours of dose time + monthly Information Motivation Behavioral Skills (IMB)-based counseling sessions using Wisepill data for feedback (up to 9 months) vs. no intervention | Wisepill [% and threshold, intervention period]; Intervention period | Intervention = 78.55% (SD=23.9) Control = 75.89% (SD=24.5) |
Total Scoreb = 16 Rating = Fair |
| Nyamathi et al., 2012 (52) | Nursing Research | Andra Pradesh, India | 68 women living with AIDS and on ART for at least 3 months; mean age: 31.2; 52% married; 22% completed secondary education | Asha-Life intervention consisting of 6 group classes and home visits and assistance in overcoming barrier to care by Accredited Social Health Activists (Ashas) vs. 6 group classes time matched to intervention with Asha visits that were less supportive; both lasted 6 months | Pill count [%, past month]; monthly for 6 months | Intervention = 41.7% (SD=9.5) Control = 54.9% (SD=16.9) |
Total Score = 18 Rating = Fair |
| Sarna et al., 2017 (39) | 12th International Conference on HIV Treatment and Prevention Adherence | Kisumu, Kenya | 404 pregnant women (14-36 weeks); mean age: 25; 82% married | Individual self-regulation theory based counseling delivered via cell-phone (maximum of 24 antenatal calls and 16 postnatal calls) vs. standard care | Pharmacy refills [proportion above 90%, time frame unclear]; delivery, 6 weeks postpartum, 14 weeks postpartum | Baseline data not reported | Total Scoreb = 15 Rating = Fair |
| Surilena et al., 2014 (40) | Acta Medica Indonesiana: The Indonesian Journal of Internal Medicine | Jakarta, Indonesia | 160 women infected through their husband/partner; mean age: 33.51; 93% married | Rational emotive behavior therapy (REBT) 6 sessions of individual therapy/week and 2 session of group therapy/week (8 weeks) vs. no intervention | SR (scale not specified [%, past week]); pill count [%, past week]; weekly for 8 weeks | Intervention = 74% (95% CI: [69.0, 75.3]), (Self-report) Control = 77% (95% CI: [71.8, 80.3]) |
Total Score = 17 Rating = Fair |
| Webel, 2010 (41) | AIDS Care | San Francisco, USA | 89 women; mean age: 46.9; 3% married; 62% completed secondary education | Peer-based HIV symptom management intervention using the Positive Self-Management Program (PSMP) delivered to groups (7 weekly sessions) vs. control condition received a copy of HIV Symptom Management: A Manual for People Living with HIV | SR (revised ACTG [% of missed doses, past 7 days]); baseline, weeks 2, 6, 10 and 14 | Intervention = 6.98 (SD=17.53)c Control = 7.92 (SD=18.81) |
Total Score = 18 Rating = Fair |
| Wyatt et al., 2004 (59) | AIDS and Behavior | Los Angeles, USA | 147 women with a history of sexual abuse; mean age: 41; 38% married; 56% completed secondary education | Enhanced Sexual Health Intervention (ESHI) risk reduction group counseling and weekly calls (11 weeks) vs. attention wait-list control (1 group session and 11 weekly calls) | SR (How many days in the past 2 weeks had they taken their HIV medications “exactly as prescribed (on schedule and the correct dose)” [%, 2 weeks]; post-test (after 11 weeks) | Baseline data not reported | Total Score = 20 Rating = Good |
Notes: SR=self-report; MEMS=medication event monitoring system; VAS=visual-analog scale; AGAS=Antiretroviral General Adherence Scale; ACTG=AIDS Clinic Trials Group; AMS=Adherence to Medication Scale; SMS=short message service; NR=not reported; PMTCT=prevention of mother to child transmission; ART=antiretroviral therapy;
a
Note= Only one measure is reported per study. In studies that reported multiple measures of adherence, the referenced measure is in parentheses and measures with percentages was preferred.
b
Note = the methodological coding for these studies may be biased due to the fact that coding was based on conference abstracts and slide presentations rather than full manuscripts.
c
Note = when calculating the effect sizes for this study, these values were transformed to represent % adherence rather than % missed