Table 6.
Summary of findings comparison 2
| Summary of findings: Self-management interventions compared to control in adolescents living with HIV | |||||
|---|---|---|---|---|---|
| Patient or population: Adolescents living with HIV; Setting: Low-, middle-, and high-income countries; Intervention: Self-management interventions with all 3 components; Comparison: Usual care | |||||
| Outcome | Follow-up | Pooled effect (95%CI) | No. of participants (studies) | Certainty of evidence (GRADE) | Comments |
| Confidence | 6 months | MD 0.80 (−0.12 to 1.72) | 93 (1 trial) |
⨁◯◯◯ VERY LOW a,b,c |
HIV self-management interventions compared to usual care for adolescents living with HIV may make little or no difference to confidence at 6-month follow-up, but the evidence is very uncertain. |
| Adherence (self-reported) | 6 months | SMD 0.67 (0.27 to 1.07) | 107 (2 trials) |
⨁◯◯◯ VERY LOW a,b,c |
HIV self-management interventions compared to usual care for adolescents living with HIV may increase self-reported adherence at 6-month follow-up, but the evidence is very uncertain. |
| Adherence (more than 95%) | 9 months | RR 1.14 (1.20 to 1.65) | 177 (1 trial) |
⨁◯◯◯ VERY LOW a,b,c |
HIV self-management interventions compared to usual care for adolescents living with HIV may increase the likelihood of achieving over 95% adherence at 9-month follow-up, but the evidence is very uncertain. |
| Sexual risk behaviour | 3 months | MD −11.97 (−25.45 to 1.51) | 51 (1 trial) |
⨁◯◯◯ VERY LOW a,b,c |
HIV self-management interventions compared to usual care for adolescents living with HIV may make little or no difference to sexual risk behaviour at 3-month follow-up, but the evidence is very uncertain. |
| Viral load (log 10) | 3 months | MD −0.66 (−1.21 to − 0.11) | 51 (1 trial) |
⨁◯◯◯ VERY LOW a,b,c |
HIV self-management interventions compared to usual care for adolescents living with HIV may decrease viral load at 3-month follow-up and may make little to no difference at 6-month follow-up, but the evidence is very uncertain. |
| 6 months | MD −0.84 (−1.69 to 0.01) | 93 (1 trial) | |||
| Depression | 6 months |
MD −0.60 (−2.67 to 1.47) |
93 (1 trial) |
⨁◯◯◯ VERY LOW a,b,c |
HIV self-management interventions compared to usual care for adolescents living with HIV may make little or no difference to depression at 6-month follow-up, but the evidence is very uncertain. |
CI Confidence interval, MD Mean difference, SMD Standardised mean difference, RR Risk ratio
GRADE Working Group: Grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
Footnotes: Explanation of GRADE certainty of evidence
a Downgraded by 1 for serious concerns about risk of bias in at least one domain
b Downgraded by 1 for indirectness, as studies did not only include adolescents (age 10 to 19)
c Downgraded by 1 for serious concerns about imprecision with wide 95%CI intervals and small sample sizes