A Cochrane review [Abstract] 1 included 19 RCTs involving a total of 2,159 participants. It was not possible to conduct a meta-analysis due to study heterogeneity with respect to populations, interventions, comparison groups, outcomes, and length of follow-up. Sample sizes ranged from 22 to 367. Interventions included cognitive behavioral therapy, motivational interviewing, medication management strategies, and interventions indirectly targeting adherence, such as programs directed to reduce risky sexual behaviours. Interventions targeting practical medication management skills, those administered to individuals vs. groups, and those interventions delivered over 12 weeks or more were associated with improved adherence outcomes (10 studies). Interventions targeting marginalized populations such as women or Latinos were not successful at improving adherence. It was not clear whether effective adherence interventions were associated with improved virological or immunological outcomes.
Comment: The quality of evidence is downgraded by study quality, inconsistency, indirectness of evidence, and by imprecise results.
Primary/Secondary Keywords