Self-management interventions for adolescents living with HIV : a systematic review
Date
2021-05-07
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
BMC (part of Springer Nature)
Abstract
Background: Self-management interventions aim to enable people living with chronic conditions to increase
control over their condition in order to achieve optimal health and may be pertinent for young people with
chronic illnesses such as HIV. Our aim was to evaluate the effectiveness of self-management interventions for
improving health-related outcomes of adolescents living with HIV (ALHIV) and identify the components that are
most effective, particularly in low-resource settings with a high HIV burden.
Methods: We considered randomised controlled trials (RCTs), cluster RCTs, non-randomised controlled trials (non-
RCTs) and controlled before-after (CBA) studies. We did a comprehensive search up to 1 August 2019. Two authors
independently screened titles, abstracts and full texts, extracted data and assessed the risk of bias. We synthesised
results in a meta-analysis where studies were sufficiently homogenous. In case of substantial heterogeneity, we
synthesised results narratively. We assessed the certainty of evidence using GRADE and presented our findings as
summaries in tabulated form.
Results: We included 14 studies, comprising 12 RCTs and two non-RCTs. Most studies were conducted in the
United States, one in Thailand and four in Africa. Interventions were diverse, addressing a variety of selfmanagement
domains and including a combination of individual, group, face-to-face, cell phone or information
communication technology mediated approaches. Delivery agents varied from trained counsellors to healthcare
workers and peers. Self-management interventions compared to usual care for ALHIV made little to no difference to
most health-related outcomes, but the evidence is very uncertain. Self-management interventions may increase
adherence and decrease HIV viral load, but the evidence is very uncertain. We could not identify any particular
components of interventions that were more effective for improving certain outcomes.
Conclusion: Existing evidence on the effectiveness of self-management interventions for improving health-related
outcomes of ALHIV is very uncertain. Self-management interventions for ALHIV should take into account the
individual, social and health system contexts. Intervention components need to be aligned to the desired
outcomes.
Description
CITATION: Crowley, T. & Rohwer, A. 2021. Self-management interventions for adolescents living with HIV : a systematic review. BMC Infectious Diseases, 21:431, doi:10.1186/s12879-021-06072-0.
The original publication is available at https://bmcinfectdis.biomedcentral.com
The original publication is available at https://bmcinfectdis.biomedcentral.com
Keywords
Self-management, HIV/AIDS, HIV/AIDS affected children, HIV/AIDS intervention programmes
Citation
Crowley, T. & Rohwer, A. 2021. Self-management interventions for adolescents living with HIV : a systematic review. BMC Infectious Diseases, 21:431, doi:10.1186/s12879-021-06072-0