Evidence for Technology Interventions to Promote ART Adherence in Adult Populations: a Review of the Literature 2012-2015

Abstract

Leveraging technology to enhance antiretroviral therapy (ART) adherence, and factors associated with it, has tremendous appeal as a low-cost, generalizable strategy to offer high-quality adherence support given an increasingly limited workforce. As the numbers of individuals living with HIV entering care and initiating ART are expected to increase substantially worldwide in the next decade, capacity to support ART adherence is needed and use of computers, internet, and mobile phones has the potential to offer those efficiencies-provided they are effective. This review summarizes recent advances in the evidence base for technology-driven, technology-delivered, or technology-enhanced ART adherence intervention approaches. A PubMed search limited to January 2013 through July 2015 identified 13 qualifying studies evaluating computer-delivered interventions, internet approaches, mobile phone technologies, and electronic dose monitoring with triggered messaging and data-informed counseling. Considerable support for each area has emerged, with the majority of studies reviewed demonstrating significant effects on ART adherence and clinical outcomes. Gaps are identified and recommendations offered.

Keywords: ART adherence; Intervention; Review; Synthesis; Technology.

Conflict of interest statement

Compliance with Ethics Guidelines: Conflict of Interest: Dr. Amico is the recipient of an unrestricted educational grant from Gilead Sciences through the University of Michigan.

Figures

Figure 1. Search results and studies excluded and included