{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:23:14Z","timestamp":1788546194783,"version":"build-2803163510"},"reference-count":84,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Optimal adherence to antiretroviral therapy (ART) remains the bedrock of effective therapy and management of human immunodeficiency virus (HIV). This systematic review examines the effect of interventions in improving ART adherence in sub-Saharan Africa (SSA), which bears the largest global burden of HIV infection. In accordance with PRISMA guidelines, and based on our inclusion and exclusion criteria, PUBMED, MEDLINE, and Google Scholar databases were searched for published studies on ART adherence interventions from 2010 to 2019. Thirty-one eligible studies published between 2010 to 2019 were identified, the categories of interventions were structural, behavioral, biological, cognitive, and combination. Study characteristics varied across design, intervention type, intervention setting, country, and outcome measurements. Many of the studies were behavioral interventions conducted in hospitals with more studies being randomized controlled trial (RCT) interventions. Despite the study variations, twenty-four studies recorded improvements. Notwithstanding, more quality studies such as RCTs should be conducted, especially among key affected populations (KAPs) to control transmission of resistant strains of the virus. Reliable objective measures of adherence should replace the conventional subjective self-report. Furthermore, long-term interventions with longer duration should be considered when evaluating the effectiveness of interventions.<\/jats:p>","DOI":"10.3390\/ijerph18052477","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T05:10:16Z","timestamp":1614748216000},"page":"2477","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Interventions to Improve Adherence to Antiretroviral Therapy (ART) in Sub-Saharan Africa: An Updated Systematic Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1318-9186","authenticated-orcid":false,"given":"Panmial Priscilla","family":"Damulak","sequence":"first","affiliation":[{"name":"Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia"},{"name":"Department of Public Health, Faculty of Basic Medical Sciences, Baze University, Abuja, Plot 686, Cadastral Zone C 00, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suriani","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1488-1235","authenticated-orcid":false,"given":"Rosliza","family":"Abdul Manaf","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salmiah","family":"Mohd Said","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri Kembangan 43400, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oche","family":"Agbaji","sequence":"additional","affiliation":[{"name":"AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Jos 2076, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1001\/jama.2014.4754","article-title":"An HIV cure: Feasibility, discovery, and implementation","volume":"312","author":"Fauci","year":"2014","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1001\/jama.296.6.679","article-title":"Adherence to antiretroviral therapy in sub-Saharan Africa and North America: A meta-analysis","volume":"296","author":"Mills","year":"2006","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Langebeek, N., Gisolf, E.H., Reiss, P., Vervoort, S.C., Hafsteinsd\u00f3ttir, T.B., Richter, C., Sprangers, M.A., and Nieuwkerk, P.T. (2014). Predictors and correlates of adherence to combination antiretroviral therapy (ART) for chronic HIV infection: A meta-analysis. BMC Med., 12.","DOI":"10.1186\/s12916-014-0142-1"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/01.aids.0000433238.93986.35","article-title":"Longitudinal assessment of associations between food insecurity, antiretroviral adherence and HIV treatment outcomes in rural Uhganda","volume":"28","author":"Weiser","year":"2014","journal-title":"AIDS"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/cit665","article-title":"Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America","volume":"58","author":"Aberg","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"21","DOI":"10.7326\/0003-4819-133-1-200007040-00004","article-title":"Adherence to protease inhibitor therapy and outcomes in patients with HIV infection","volume":"133","author":"Paterson","year":"2000","journal-title":"Ann. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1097\/00042560-200205010-00014","article-title":"Impact of adherence and highly active antiretroviral therapy on survival in HIV-infected patients","volume":"30","author":"Knobel","year":"2002","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1097\/00002030-200106150-00015","article-title":"Non-adherence to highly active antiretroviral therapy predicts progression to AIDS","volume":"15","author":"Bangsberg","year":"2001","journal-title":"Aids"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Hansana, V., Sanchaisuriya, P., Durham, J., Sychareun, V., Chaleunvong, K., Boonyaleepun, S., and Schelp, F.P. (2013). Adherence to antiretroviral therapy (ART) among people living with HIV (PLHIV): A cross-sectional survey to measure in Lao PDR. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-617"},{"key":"ref_10","first-page":"789","article-title":"Adherence and viral suppression among participants of the patient-centered human immunodeficiency virus (HIV) care model project: A collaboration between community-based pharmacists and HIV clinical providers","volume":"70","author":"Byrd","year":"2020","journal-title":"Clin. Infect. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1056\/NEJMoa1600693","article-title":"Antiretroviral therapy for the prevention of HIV-1 transmission","volume":"375","author":"Cohen","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1001\/jama.2016.5148","article-title":"Sexual activity without condoms and risk of HIV transmission in serodifferent couples when the HIV-positive partner is using suppressive antiretroviral therapy","volume":"316","author":"Rodger","year":"2016","journal-title":"JAMA"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1097\/QAD.0000000000000243","article-title":"Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy","volume":"28","author":"May","year":"2014","journal-title":"AIDS"},{"key":"ref_14","unstructured":"UNAIDS (2020, November 20). 90-90-90 Treatment Target. Available online: https:\/\/www.unaids.org\/en\/90-90-90."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"34","DOI":"10.2174\/1874613601610010034","article-title":"HIV Infection and AIDS in Sub-Saharan Africa: Current Status, Challenges and Opportunities","volume":"10","author":"Kharsany","year":"2016","journal-title":"Open AIDS J."},{"key":"ref_16","unstructured":"World Health Organization (2021, January 10). HIV\/AIDS. Available online: https:\/\/www.afro.who.int\/health-topics\/hivaids."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1177\/1545109712459041","article-title":"Antiretroviral therapy adherence support: Recommendations and future directions","volume":"12","author":"Amico","year":"2013","journal-title":"J. Int. Assoc. Provid. AIDS Care (JIAPAC)"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1016\/S1473-3099(11)70181-5","article-title":"Interventions to increase antiretroviral adherence in sub-Saharan Africa: A systematic review of evaluation studies","volume":"11","author":"Chaiyachati","year":"2011","journal-title":"Lancet Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Liberati, A., Altman, D.G., Tetzlaff, J., Mulrow, C., G\u00f8tzsche, P.C., Ioannidis, J.P., Clarke, M., Devereaux, P.J., Kleijnen, J., and Moher, D. (2009). The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration. PLoS Med., 6.","DOI":"10.2427\/5768"},{"key":"ref_20","first-page":"167","article-title":"What is your research question? An introduction to the PICOT format for clinicians","volume":"56","author":"Riva","year":"2012","journal-title":"J. Can. Chiropr. Assoc."},{"key":"ref_21","unstructured":"Higgins, J.P.T., and Green, S. (2011). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011], The Cochrane Collaboration. Available online: www.handbook.cochrane.org."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e000125","DOI":"10.1136\/bmjgh-2016-000125","article-title":"Determinants of adherence to antiretroviral therapy among HIV-positive adults in sub-Saharan Africa: A systematic review","volume":"1","author":"Heestermans","year":"2016","journal-title":"BMJ Glob. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1089\/apc.2014.0308","article-title":"Interventions for enhancing adherence to antiretroviral therapy (ART): A systematic review of high quality studies","volume":"29","author":"Mbuagbaw","year":"2015","journal-title":"AIDS Patient Care STDS"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Achieng, L., Musangi, H., Ong\u2019uti, S., Ombegoh, E., Bryant, L., Mwiindi, J., Smith, N., and Keiser, P. (2012). An observational cohort comparison of facilitators of retention in care and adherence to anti-eetroviral therapy at an HIV treatment center in Kenya. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0032727"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Atanga, P.N., Ndetan, H.T., Fon, P.N., Meriki, H.D., Muffih, T.P., Achidi, E.A., Hoelscher, M., and Kroidl, A. (2018). Using a composite adherence tool to assess ART response and risk factors of poor adherence in pregnant and breastfeeding HIV-positive Cameroonian women at 6 and 12 months after initiating option B+. BMC Pregnancy Child., 18.","DOI":"10.1186\/s12884-018-2058-9"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Bajunirwe, F., Ayebazibwe, N., Mulogo, E., Eng, M., McGrath, J., Kaawa-Mafigiri, D., Mugyenyi, P., and Seth, A.J. (2019). Effectiveness of a mobile antiretroviral pharmacy and HIV care intervention on the continuum of HIV care in rural Uganda. BioRxiv, 533950.","DOI":"10.1101\/533950"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/09540121.2013.806770","article-title":"The VUKA family program: Piloting a family-based psychosocial intervention to promote health and mental health among HIV infected early adolescents in South Africa","volume":"26","author":"Bhana","year":"2014","journal-title":"AIDS Care"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Boeke, C.E., Nabitaka, V., Rowan, A., Guerra, K., Nawaggi, P., Mulema, V., Bigira, V., Magongo, E., Mucheri, P., and Musoke, A. (2018). Results from a proactive follow-up intervention to improve linkage and retention among people living with HIV in Uganda: A pre-\/post-study. BMC Health Serv. Res., 18.","DOI":"10.1186\/s12913-018-3735-0"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Boruett, P., Kagai, D., Njogo, S., Nguhiu, P., Awuor, C., Gitau, L., Chalker, J., Ross-Degnan, D., Wahlstr\u00f6m, R., and Tomson, G. (2013). Facility-level intervention to improve attendance and adherence among patients on anti-retroviral treatment in Kenya\u2014A quasi-experimental study using time series analysis. BMC Health Serv. Res., 13.","DOI":"10.1186\/1472-6963-13-242"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1177\/2010105818760923","article-title":"Do peer support groups have an effect on medication adherence? A study among people living with HIV\/AIDS in Enugu State, Nigeria","volume":"27","author":"Chime","year":"2018","journal-title":"Proc. Singap. Healthc."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Chung, M.H., Richardson, B.A., Tapia, K., Benki-Nugent, S., Kiarie, J.N., Simoni, J.M., Overbaugh, J., Attwa, M., and John-Stewart, G.C. (2011). A randomized controlled trial comparing the effects of counseling and alarm device on HAART adherence and virologic outcomes. PLoS Med., 8.","DOI":"10.1371\/journal.pmed.1000422"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"279","DOI":"10.2174\/1570162X13666150407143838","article-title":"Socio-demographic and adherence factors associated with viral load suppression in HIV-infected adults initiating therapy in northern Nigeria: A randomized controlled trial of a peer support intervention","volume":"13","author":"Coker","year":"2015","journal-title":"Curr. HIV Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e50","DOI":"10.1097\/QAI.0b013e31826a6aee","article-title":"Improved survival and antiretroviral treatment outcomes in adults receiving community-based adherence support: 5-year results from a multicentre cohort study in South Africa","volume":"61","author":"Fatti","year":"2012","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1080\/09540121.2014.986053","article-title":"An assessment of HIV treatment outcomes among utilizers of semi-mobile clinics in rural Kenya","volume":"27","author":"Gorman","year":"2015","journal-title":"AIDS Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e127","DOI":"10.1097\/QAI.0000000000000664","article-title":"Implementation and Operational Research: Pulling the Network Together: Quasiexperimental Trial of a Patient-Defined Support Network Intervention for Promoting Engagement in HIV Care and Medication Adherence on Mfangano Island, Kenya","volume":"69","author":"Hickey","year":"2015","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_36","first-page":"14","article-title":"Motivational groups support adherence to antiretroviral therapy and use of risk reduction behaviors in HIV positive Nigerian women: A pilot study","volume":"16","author":"Holstad","year":"2012","journal-title":"Afr. J. Reprod. Health"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1080\/09540121.2010.498909","article-title":"An evaluation of the impact of a community-based adherence support programme on ART outcomes in selected government HIV treatment sites in South Africa","volume":"23","author":"Igumbor","year":"2011","journal-title":"AIDS Care"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Jobanputra, K., Parker, L.A., Azih, C., Okello, V., Maphalala, G., Kershberger, B., Khogali, M., Lujan, J., Antierens, A., and Teck, R. (2015). Factors associated with virological failure and suppression after enhanced adherence counselling, in children, adolescents and adults on antiretroviral therapy for HIV in Swaziland. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0116144"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jana.2012.06.009","article-title":"Determinants of engagement in HIV treatment and care among Zambians new to antiretroviral therapy","volume":"24","author":"Jones","year":"2013","journal-title":"J. Assoc. Nurses AIDS Care"},{"key":"ref_40","first-page":"1","article-title":"The Use of a Brief, Active Visualisation Intervention to Improve Adherence to Antiretroviral Therapy in Non-adherent Patients in South Africa","volume":"26","author":"Jones","year":"2018","journal-title":"AIDS Behav."},{"key":"ref_41","first-page":"1","article-title":"Stigma management intervention to improve antiretroviral therapy adherence: Phase-I test of concept trial, Cape Town South Africa","volume":"1","author":"Kalichman","year":"2018","journal-title":"Glob. Public Health"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1007\/s10461-011-9927-9","article-title":"Improving clinic attendance and adherence to antiretroviral therapy through a treatment supporter intervention in Uganda: A randomized controlled trial","volume":"15","author":"Kunutsor","year":"2011","journal-title":"AIDS Behav."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e125","DOI":"10.1097\/QAI.0b013e3182987ce6","article-title":"Noninferiority of a task-shifting HIV care and treatment model using peer counselors and nurses among Ugandan women initiated on ART: Evidence from a randomized trial","volume":"63","author":"Kiweewa","year":"2013","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"302","DOI":"10.4103\/1119-3077.113451","article-title":"Adherence counseling and reminder text messages improve uptake of antiretroviral therapy in a tertiary hospital in Nigeria","volume":"16","author":"Maduka","year":"2013","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Mbuagbaw, L., Thabane, L., Ongolo-Zogo, P., Lester, R.T., Mills, E.J., Smieja, M., Dolovich, L., and Kouanfack, C. (2012). The Cameroon Mobile Phone SMS (CAMPS) trial: A randomized trial of text messaging versus usual care for adherence to antiretroviral therapy. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0046909"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"144","DOI":"10.4102\/sajhivmed.v13i3.128","article-title":"Treating depression in HIV-positive patients affects adherence","volume":"13","author":"Moosa","year":"2012","journal-title":"South. Afr. J. HIV Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"24198","DOI":"10.3402\/gha.v7.24198","article-title":"Improving adherence to antiretroviral treatment in Uganda with a low-resource facility-based intervention","volume":"7","author":"Obua","year":"2014","journal-title":"Glob. Health Action"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1097\/QAI.0000000000000770","article-title":"A randomised controlled trial of real-time electronic adherence monitoring with text message dosing reminders in people starting first-line antiretroviral therapy","volume":"70","author":"Orrell","year":"2015","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1080\/17290376.2012.745640","article-title":"Efficacy of a lay health worker led group antiretroviral medication adherence training among non-adherent HIV-positive patients in KwaZulu-Natal, South Africa: Results from a randomized trial","volume":"9","author":"Peltzer","year":"2012","journal-title":"Sahara J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1007\/s10461-014-0988-4","article-title":"Enhancing Lay Counselor Capacity to Improve Patient Outcomes with Multimedia Technology","volume":"19","author":"Robbins","year":"2015","journal-title":"AIDS Behav."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1097\/QAI.0b013e3181eb5edb","article-title":"Task-shifting of antiretroviral delivery from health care workers to persons living with HIV\/AIDS: Clinical outcomes of a community-based program in Kenya","volume":"55","author":"Selke","year":"2010","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_52","first-page":"68","article-title":"Family nutritional support improves survival, immune restoration and adherence in HIV patients receiving ART in developing country","volume":"19","author":"Serrano","year":"2010","journal-title":"Asia Pac. J. Clin. Nutr."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"171","DOI":"10.4172\/2155-6113.1000171","article-title":"Clinic-Based Food Assistance is Associated with Increased Medication Adherence among HIV-Infected Adults on Long-Term Antiretroviral Therapy in Zambia","volume":"3","author":"Tirivayi","year":"2012","journal-title":"J. AIDS Clin. Res."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Willis, N., Milanzi, A., Mawodzeke, M., Dziwa, C., Armstrong, A., Yekeye, I., Mtshali, P., and James, V. (2019). Effectiveness of community adolescent treatment supporters (CATS) interventions in improving linkage and retention in care, adherence to ART and psychosocial well-being: A randomised trial among adolescents living with HIV in rural Zimbabwe. BMC Public Health, 19.","DOI":"10.1186\/s12889-019-6447-4"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction\u2014GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J. Clin. Epidemiol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1093\/her\/cyr040","article-title":"Interventions to promote physical activity among young and adolescent girls: A systematic review","volume":"26","author":"LaVoi","year":"2011","journal-title":"Health Educ. Res."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1716","DOI":"10.1111\/1471-0528.15199","article-title":"Randomised controlled trials\u2014The gold standard for effectiveness research","volume":"125","author":"Hariton","year":"2018","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1046\/j.1365-2702.2003.00662.x","article-title":"Hierarchy of evidence: A framework for ranking evidence evaluating healthcare interventions","volume":"12","author":"Evans","year":"2003","journal-title":"J. Clin. Nurs."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1093\/ejo\/cjv046","article-title":"Randomized controlled trial: The gold standard or an unobtainable fallacy?","volume":"37","author":"Bondemark","year":"2015","journal-title":"Eur. J. Orthod."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"279","DOI":"10.4300\/JGME-D-12-00156.1","article-title":"Using Effect Size-or Why the P Value Is Not Enough","volume":"4","author":"Sullivan","year":"2012","journal-title":"J. Grad. Med. Educ."},{"key":"ref_61","unstructured":"World Health Organization (2021, January 15). HIV\/AIDS. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hiv-aids."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1007\/s13181-013-0325-8","article-title":"A review of the toxicity of HIV medications","volume":"10","author":"Margolis","year":"2014","journal-title":"J. Med. Toxicol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1089\/apc.2014.0195","article-title":"Medication adherence among men who have sex with men at risk for HIV infection in the United States: Implications for pre-exposure prophylaxis implementation","volume":"28","author":"Liu","year":"2014","journal-title":"AIDS Patient Care STDS"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1007\/s10461-011-9942-x","article-title":"Adherence to highly active antiretroviral therapy (HAART): A meta-analysis","volume":"15","author":"Ortego","year":"2011","journal-title":"AIDS Behav."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Sangeda, R.Z., Mosha, F., Prosperi, M., Aboud, S., Vercauteren, J., Camacho, R.J., Lyamuya, E.F., Van Wijngaerden, E., and Vandamme, A.M. (2014). Pharmacy refill adherence outperforms self-reported methods in predicting HIV therapy outcome in resource-limited settings. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-1035"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12981-020-00265-4","article-title":"Comparing self-reported medication adherence measures with hair antiretroviral concentration among people living with HIV in Guangxi, China","volume":"17","author":"Zhang","year":"2020","journal-title":"AIDS Res. Ther."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1097\/01.aids.0000180094.04652.3b","article-title":"No room for complacency about adherence to antiretroviral therapy in sub-Saharan Africa","volume":"19","author":"Gill","year":"2005","journal-title":"AIDS"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-10-720","article-title":"Social desirability and self-reported health risk behaviors in web-based research: Three longitudinal studies","volume":"10","author":"Crutzen","year":"2010","journal-title":"BMC Public Health"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/s11904-018-0377-0","article-title":"Adherence measurements in HIV: New advancements in pharmacologic methods and real-time monitoring","volume":"15","author":"Haberer","year":"2018","journal-title":"Curr. HIV AIDS Rep."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.jclinepi.2004.04.002","article-title":"A time-to-prescription-refill measure of antiretroviral adherence predicted changes in viral load in HIV","volume":"57","author":"Grossberg","year":"2004","journal-title":"J. Clin. Epidemiol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1089\/aid.2008.0035","article-title":"Simple adherence assessments to predict virologic failure among HIV-infected adults with discordant immunologic and clinical responses to antiretroviral therapy","volume":"24","author":"Goldman","year":"2008","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_72","unstructured":"Warne, P., Robbins, R., Anderson, P., Gouse, H., Joska, J., Leu, C.S., Mtingeni, Y., Henry, M., Rios, J.L., and Castillo-Mancilla, J. (2015). Utility of Dried Blood Spot-Derived ARV Biomarkers as an Objective Measure of Treatment Adherence in South Africa, IAPAC Adherence."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1023\/A:1009503320498","article-title":"Measuring adherence among HIV-infected persons: Is MEMS consummate technology?","volume":"5","author":"Samet","year":"2001","journal-title":"AIDS Behav."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e5","DOI":"10.1016\/S2352-3018(16)30191-6","article-title":"Actionable adherence monitoring to optimise intervention","volume":"4","author":"Haberer","year":"2017","journal-title":"Lancet HIV"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1097\/COH.0000000000000393","article-title":"Technological methods to measure adherence to antiretroviral therapy and preexposure prophylaxis","volume":"12","author":"Garrison","year":"2017","journal-title":"Curr. Opin. HIV Aids"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1007\/s10461-006-9133-3","article-title":"Assessing antiretroviral adherence via electronic drug monitoring and self-report: An examination of key methodological issues","volume":"11","author":"Pearson","year":"2007","journal-title":"AIDS Behav."},{"key":"ref_77","first-page":"957862","article-title":"Feasibility and acceptability of a real-time adherence device among HIV-positive IDU patients in China","volume":"2013","author":"Gifford","year":"2013","journal-title":"AIDS Res. Treat."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"155","DOI":"10.5001\/omj.2011.38","article-title":"Patient medication adherence: Measures in daily practice","volume":"26","author":"Jimmy","year":"2011","journal-title":"Oman Med. J."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"217047","DOI":"10.1155\/2015\/217047","article-title":"Medication Adherence Measures: An Overview","volume":"2015","author":"Lam","year":"2015","journal-title":"Biomed. Res. Int."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1080\/09540121.2018.1533224","article-title":"Counseling for improving adherence to antiretroviral treatment: A systematic review","volume":"31","author":"Carcamo","year":"2019","journal-title":"Aids Care"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"e03627","DOI":"10.1590\/s1980-220x2019009803627","article-title":"Effectiveness of interventions for adherence to antiretroviral therapy in adults with HIV: A systematic review","volume":"54","author":"Zuge","year":"2020","journal-title":"Rev. Esc. Enferm. Usp."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"S187","DOI":"10.1097\/QAD.0000000000000252","article-title":"Interventions to improve adherence to antiretroviral therapy: A rapid systematic review","volume":"28","author":"Chaiyachati","year":"2014","journal-title":"AIDS"},{"key":"ref_83","unstructured":"NACA (2021, February 22). National HIV\/AIDS Strategic Framework 2017\u20132021. Available online: https:\/\/www.childrenandaids.org\/sites\/default\/files\/2017-11\/NATIONAL-HIV-AND-AIDS-STRATEGIC-FRAMEWORK.pdf."},{"key":"ref_84","unstructured":"UNAIDS (2021, February 22). UNAIDS DATA 2017. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/20170720_Data_book_2017_en.pdf."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/5\/2477\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:31:49Z","timestamp":1760160709000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/5\/2477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,3]]},"references-count":84,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["ijerph18052477"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18052477","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,3]]}}}