Computer-based HIV adherence promotion interventions: a systematic review

Researchers have instituted a range of methodologies to increase access to HIV adherence interventions. This article reviews studies published through January 2014 utilizing computer-based delivery of such interventions to persons living with HIV. A systematic review of five databases identified ten studies (three RCTs, three pilot studies, three feasibility studies, and one single-group trial) that met the inclusion criteria. Descriptions of the interventions’ content and characteristics are included. Interventions varied widely in terms of program structure, theoretical framework, and content. Only six studies reported medication adherence outcomes. Of these, four (five RCTS and one single group pre-post test) reported significant improvement in adherence using various measures, and two approached significance. Results suggest that computer-delivered adherence interventions are feasible and acceptable among both HIV-positive adolescents and adults. Definitive conclusions regarding clinical impact cannot be drawn due to the small number of adequately powered randomized trials in this review. Additional randomized controlled research is needed to draw inferences regarding intervention efficacy.