title: Effect of home-based interventions on virologic outcomes in adults receiving antiretroviral therapy in Africa: a meta-analysis.
abstract: BACKGROUND
  The success of adherence to combination antiretroviral therapy (ART) in sub-Saharan Africa is hampered by factors that are unique to this setting. Home based interventions have been identified as possible strategies for decentralizing ART care and improving access and adherence to ART. There is need for evidence at individual- or community-level of the benefits of home-based interventions in improving HIV suppression in African patients receiving ART.
  
  
  METHODS
  We conducted a systematic review and meta-analysis of the literature to assess the effect of home-based interventions on virologic outcomes in adults receiving ART in Africa.
  
  
  RESULTS
  A total of 260 publications were identified by the search strategy, 249 were excluded on initial screening and 11 on full review, leaving 5 publications for analysis. The overall OR of virologic suppression at 12 months after starting ART of home-based interventions to standard of care was 1.13 (95% CI: 0.51-2.52).
  
  
  CONCLUSIONS
  There was insufficient data to know whether there is a difference in HIV suppression at 12 months in the home-based arm compared with the standard of care arm in adults receiving ART in Africa. Given the few trials conducted from Africa, there is need for further research that measures the effects of home-based models on HIV suppression in African populations.
authors.affiliation: Zambia AIDS-related TB Project, School of Medicine, P,O Box 50697, Ridgeway campus, Lusaka, Zambia. Nathaniel@zambart.org.zm.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Chishinga
authors.forename: Peter
authors.initials: P
authors.lastname: Godfrey-Faussett
authors.forename: Katherine
authors.initials: K
authors.lastname: Fielding
authors.forename: Helen
authors.initials: H
authors.lastname: Ayles
mesh_terms: D000328:Adult; D000349:Africa; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy*; D006301:Health Services Needs and Demand; D006792:House Calls; D006801:Humans; D055118:Medication Adherence; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents