title: Improving Engagement in the HIV Care Cascade: A Systematic Review of Interventions Involving People Living with HIV/AIDS as Peers.
abstract: Improving patient engagement in HIV care is critical for maximizing the impact of antiretroviral therapy (ART). We conducted a systematic review of studies that used HIV-positive peers to bolster linkage, retention, and/or adherence to ART. We searched articles published and indexed in Pubmed, PsycINFO, and CINAHL between 1996 and 2014. Peers were required to be HIV-positive. Studies were restricted to those published in English. Nine studies with n = 4658 participants met the inclusion criteria. Peer-based interventions were predominantly focused on improving adherence to ART, or evaluations of retention and adherence via viral suppression. Five (56 %) were conducted in sub-Saharan Africa. Overall findings were mixed on the impact of peers on ART adherence, viral suppression, and mortality. While positive effects of peer interventions on improving linkage and retention were found, there were limited studies assessing these outcomes. Additional research is warranted to demonstrate the impact of peers on linkage and retention in diverse populations.
authors.affiliation: Department of Health Services, Policy & Practice, Brown University, 121 S. Main Street, Box G-121-6, Providence, RI, 02912, USA. becky_genberg@brown.edu.
authors.forename: Becky L
authors.initials: BL
authors.lastname: Genberg
authors.affiliation: Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Shangani
authors.affiliation: Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.
authors.forename: Kelly
authors.initials: K
authors.lastname: Sabatino
authors.affiliation: The Ontario HIV Treatment Network, Toronto, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
authors.forename: Beth
authors.initials: B
authors.lastname: Rachlis
authors.affiliation: Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|Department of Medicine, Moi University College of Health Sciences, School of Medicine, Eldoret, Kenya.
authors.forename: Juddy
authors.initials: J
authors.lastname: Wachira
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.|Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya.|Department of Medicine, Moi University College of Health Sciences, School of Medicine, Eldoret, Kenya.|Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.|Regenstrief Institute, Indianapolis, IN, USA.
authors.forename: Paula
authors.initials: P
authors.lastname: Braitstein
authors.affiliation: Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Operario
mesh_terms: D017954:Africa South of the Sahara; D019380:Anti-HIV Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003266:Continuity of Patient Care; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D055118:Medication Adherence; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D010379:Peer Group
chemical_list: D019380:Anti-HIV Agents
keywords: Antiretroviral adhernce; Linkage to HIV care; Peer interventions; Retention in HIV care; Sub-Saharan Africa; Systematic review
references.citation: J Int AIDS Soc. 2012 Nov 19;15(2):17383
references.pmid: 23199799
references.citation: AIDS Behav. 2012 Jul;16(5):1295-307
references.pmid: 22020756
references.citation: AIDS Patient Care STDS. 2007;21 Suppl 1:S49-58
references.pmid: 17563290
references.citation: AIDS Behav. 2014 Apr;18(4):706-15
references.pmid: 24469222
references.citation: AIDS Patient Care STDS. 2013 Aug;27(8):474-80
references.pmid: 23883321
references.citation: AIDS Patient Care STDS. 2014 Feb;28(2):82-90
references.pmid: 24517539
references.citation: J Int AIDS Soc. 2014 Aug 01;17:19032
references.pmid: 25095831
references.citation: J Acquir Immune Defic Syndr. 2009 Dec 1;52(4):465-473
references.pmid: 19911481
references.citation: PLoS Med. 2011 Jul;8(7):e1001056
references.pmid: 21811403
references.citation: Clin Infect Dis. 2011 Mar 15;52(6):793-800
references.pmid: 21367734
references.citation: Sex Transm Infect. 2014 Aug;90(5):388-93
references.pmid: 24926040
references.citation: Curr HIV/AIDS Rep. 2014 Dec;11(4):376-92
references.pmid: 25323298
references.citation: AIDS Patient Care STDS. 2011 Dec;25(12):719-24
references.pmid: 21391828
references.citation: J Int Assoc Provid AIDS Care. 2015 Sep-Oct;14(5):441-8
references.pmid: 25412724
references.citation: Ann Intern Med. 2009 Aug 18;151(4):264-9, W64
references.pmid: 19622511
references.citation: Ann Intern Med. 2012 Jun 5;156(11):817-33, W-284, W-285, W-286, W-287, W-288, W-289, W-290, W-291,
references.pmid: 22393036
references.citation: J Acquir Immune Defic Syndr. 2013 Aug 1;63(4):e125-32
references.pmid: 23807157
references.citation: AIDS Care. 2013 Aug;25(8):968-72
references.pmid: 23311339
references.citation: Worldviews Evid Based Nurs. 2004;1(3):176-84
references.pmid: 17163895
references.citation: Health Psychol. 2007 Jul;26(4):488-95
references.pmid: 17605569
references.citation: Am J Orthopsychiatry. 2011 Jul;81(3):351-9
references.pmid: 21729015
references.citation: PLoS One. 2010 Jun 02;5(6):e10923
references.pmid: 20532194
references.citation: J Acquir Immune Defic Syndr. 2007 Nov 1;46 Suppl 2:S35-47
references.pmid: 18089983
references.citation: PLoS Med. 2006 Nov;3(11):e438
references.pmid: 17121449
references.citation: J Acquir Immune Defic Syndr. 2010 Dec;55(4):483-90
references.pmid: 20683336