What can research evidence tell us about predictors and effective improvement strategies of antiretroviral therapy outcomes? Rapid evidence review

Abstract

Key findings

Findings from systematic reviews done in Ethiopia indicate sub-optimal adherence to antiretroviral therapy (ART), advanced WHO clinical stages, co-infection, CD4 count and HIV-RNA viral load at baseline are some of the determinant factors that influence ART treatment outcomes.  

Effective strategies or interventions to mitigate the barriers to ART treatment outcome were generally focused on increasing adherence to ART and access to the service.

Mobile text messaging, behavioral intervention, education, treatment supporters and adherence counseling were some of the interventions associated with improved outcome. Task shifting (from doctors to other health workers) and decentralization of service delivery were found to be effective strategies to increase access to ART services.

Different interventions designed to enhance adherence to ART show improvement but all required contextualizing to the specific setting.