***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: To assess the effectiveness of a psychosocial individual intervention to improve adherence to ART in a Brazilian reference-center , consenting PLHIV with viral load > 50 copies/ml were selected . After 4 weeks of MEMS cap use , participants were r and omized into an  intervention group ( IG ) ( n = 64 ) or control group ( CG ) ( n = 57 ) . CG received usual care only . The IG participated in a human rights-based intervention approach entailing four dialogical meetings focused on medication intake scenes . Comparison between IG and CG revealed no statistically significant difference in adherence measured at weeks 8 , 12 , 16 , 20 and 24 . Viral load ( VL ) decreased in both groups ( p < 0.0001 ) with no significant difference between study groups . The lower number of eligible patients than expected underpowered the study . Ongoing qualitative analysis should provide deeper underst and ing of the trial results . NIH Clinical Trials : NCTOO716040.ResumenPersonas viviendo con VIH con carga viral > 50 copias/ml fueron seleccionadas en un centro de referencia en Brasil para evaluar la efectividad de una intervención psicosocial individual para mejorar la adhesión a la terapia antirretroviral . Los participantes firmaron el documento de consentimiento informado . Tras 4 semanas de uso de MEMS caps , los participantes fueron aleatorizados en el grupo de intervención ( GI ) ( n = 64 ) o el grupo control ( GC ) ( n = 57 ) . El CG recibió solamente los cuidados habituales . El GI participó de una intervención basada en los derechos humanos , con cuatro reuniones dialógicas centradas en escenas de toma de medicamentos . La comparación entre GI y CG no reveló ninguna diferencia estadísticamente significativa en la adhesión medida en las semanas 8 , 12 , 16 , 20 y 24 . La carga viral ( CV ) disminuyó en ambos grupos del estudio ( p < 0.0001 ) , aunque sin significado estadístico . El número de pacientes elegibles , más pequeño del que el esperado , disminuyó el poder del estudio . El análisis cualitativo actual debe proporcionar una comprensión más profunda de los result ados del estudio . Registro del Ensayo Clínico : NCT00716040 We design ed a r and omized controlled trial of a home based intervention to improve antiretroviral adherence and to assess the impact of depressive symptoms among people living with HIV in Hunan , China . At baseline , 110 subjects reported taking 90 % or less of prescribed medication . At 6 months , when the intervention ended , 56 % of subjects in the control and 87 % of subjects in the experimental group were adherent . This difference was maintained at 12 months . In multivariate analyses , controlling for baseline visual analogue adherence scale , stigma , social support , and Center for Epidemiological Studies Depression scale , the experimental group had a significantly higher proportion of people who were adherent ( p=0.009 ) . The high prevalence of significant depressive symptoms ( 67 % ) at baseline is of concern . It is of particular importance that future studies look at the types of depression likely to be seen in these patients and differentiate early between those likely to benefit from HIV-related support and those who will require additional depression-targeted interventions Background Human immunodeficiency virus ( HIV ) treatment side effects have a deleterious impact on treatment adherence , which is necessary to optimize treatment outcomes including morbidity and mortality . Purpose To examine the effect of the Balance Project intervention , a five-session , individually delivered HIV treatment side effects coping skills intervention on antiretroviral medication adherence . Methods HIV+ men and women ( N = 249 ) on antiretroviral therapy ( ART ) with self-reported high levels of ART side effect distress were r and omized to intervention or treatment as usual . The primary outcome was self-reported ART adherence as measured by a combined 3-day and 30-day adherence assessment . Results Intent-to-treat analyses revealed a significant difference in rates of nonadherence between intervention and control participants across the follow-up time points such that those in the intervention condition were less likely to report nonadherence . Secondary analyses revealed that intervention participants were more likely to seek information about side effects and social support in efforts to cope with side effects . Conclusions Interventions focusing on skills related to ART side-effects management show promise for improving ART adherence among persons experiencing high levels of perceived ART side effects Background : Stress management interventions for HIV-positive persons have been design ed to enhance coping skills and encourage health-promoting behaviors with the hope of decreasing distress and slowing disease progression . Purpose : We examined the efficacy of a cognitive behavioral stress management ( CBSM ) intervention in combination with medication adherence training ( MAT ) in 130 gay and bisexual men living with HIV infection . Methods : Participants were r and omized to either a 10-week CBSM+MAT intervention ( n = 76 ) or a MAT-only condition ( n = 54 ) . Measures of self-reported adherence , active cognitive coping ( i.e. , acceptance and positive reinterpretation ) , avoidant coping ( i.e. , denial and behavioral disengagement ) , and depressed mood were examined over the 10-week intervention period . Results : Men in CBSM+MAT reported reductions in depressed mood and denial coping during the 10-week intervention period , but no changes in active cognitive coping or self-reported adherence were observed . Using path analysis , greater reliance on denial coping at baseline was associated with decreased depressed mood at 10 weeks . We also determined that CBSM+MAT may decrease depressed mood by reducing reliance on denial coping over the 10-week intervention period . Conclusions : Although denial may be an effective means of distress reduction in the short term , reliance on this coping strategy may result in a decreased capacity to effectively manage a variety of disease-related stressors in the long term . CBSM+MAT addresses this potentially detrimental pattern by teaching stress reduction skills that may decrease depressed mood via reduced reliance on denial coping Nigerian women comprise the fastest growing group of persons with AIDS in Africa .  Antiretroviral therapy has transformed the course of HIV/AIDS to a treatable , chronic illness worldwide . The purpose of this pilot study was to assess the efficacy of a group intervention using motivational interviewing ( MI ) to promote adherence to antiretroviral therapy ( ART ) and use of risk reduction behaviors ( RRB ) among HIV-infected women in Nigeria . Recruited participants ( n=60 ) were r and omly assigned to the motivational group or the health promotion program ( HPP ) control group . The 6 month follow-up results indicate that , compared to the control group , MI participants reported significantly higher levels of adherence to ART , higher knowledge of HIV , higher use of condoms/protection during sexual encounters and decision-making not to have sex when no protection was available . The MI participants also had fewer mean number of sexual partners . MI in group format shows promise in promoting adherence to ART and use of RRB in HIV-infected Nigerian women Objective : To determine the relative efficacy of peer support and pager messaging strategies versus usual care to improve medication adherence and clinical outcomes among HIV-positive out patients initiating or switching to a new highly active antiretroviral therapy regimen . Design : A 2 × 2 factorial r and omized controlled trial of a 3-month intervention with computer-assisted self-interviews and blood draws administered at baseline , 3 , 6 , and 9 months . Methods : HIV-positive patients at a public HIV specialty clinic in Seattle , WA ( N = 224 ) were r and omly assigned to peer support , pager messaging , both strategies , or usual care . The main outcomes were adherence according to self-report and electronic drug monitoring , CD4 count , and HIV-1 RNA viral load . Results : Intent-to-treat analyses suggested the peer intervention was associated with greater self-reported adherence at immediate postintervention . However , these effects were not maintained at follow-up assessment ; nor were there significant differences in biological outcomes . The pager intervention , on the other h and , was not associated with greater adherence but was associated with improved biological outcomes at postintervention that were sustained at follow-up . Conclusions : Analyses indicate the potential efficacy of peer support and pager messaging to promote antiretroviral adherence and biological outcomes , respectively . More potent strategies still are needed Objective : Evaluate a computerized intervention supporting  antiretroviral therapy ( ART ) adherence and HIV transmission  prevention . Design : Longitudinal r and omized controlled trial . Setting s : An academic HIV clinic and a community-based organization in Seattle . Subjects : In a total of 240 HIV-positive adults on ART , 209 completed 9-month follow-up ( 87 % retention ) . Intervention : R and omization to computerized counseling or assessment only , 4 sessions over 9 months . Main Outcome Measures : HIV-1 viral suppression , and self-reported ART adherence and transmission risks , compared using generalized estimating equations . Results : Overall , intervention participants had reduced viral load : mean 0.17 log10 decline , versus 0.13 increase in controls , P = 0.053 , and significant difference in ART adherence baseline to 9 months ( P = 0.046 ) . Their sexual transmission risk behaviors decreased ( odds ratio = 0.55 , P = 0.020 ) , a reduction not seen among controls ( odds ratio = 1.1 , P = 0.664 ) , and a significant difference in change ( P = 0.040 ) . Intervention effect was driven by those most in need ; among those with detectable virus at baseline ( > 30 copies/mL , n = 89 ) , intervention effect was mean 0.60 log10 viral load decline versus 0.15 increase in controls , P = 0.034 . ART adherence at the final follow-up was 13 points higher among intervention participants versus controls , P = 0.038 . Conclusions : Computerized counseling is promising for integrated ART adherence and safer sex , especially for individuals with problems in these areas . This is the first intervention to report improved ART adherence , viral suppression , and reduced secondary sexual transmission risk behavior HIV antiretroviral therapy ( ART ) can increase safe sex or lead to disinhibition and less condom use . We conducted one of the first controlled studies of ART effects on sexual risk behavior in sub-Saharan Africa , and the potential explanatory roles of physical and mental health . Participants ( 302 non-ART , 300 ART ) were followed for the first 12 months of HIV care in Ug and a. Multivariate intention-to-treat regression analysis showed that frequency of sex increased significantly in both groups , but more among ART patients ; when added to the model in separate analyses , changes in physical health functioning and depression were both significant predictors , as was time in HIV care , but there was no longer an ART effect . Both ART and non-ART groups had similar dramatic increases in consistent condom use over time ; however , change in depression , unlike physical health functioning , was a significant predictor of consistent condom use when added to this model , and there remained a similar level of increased condom use among ART and non-ART patients . HIV care and ART increase sexual activity and condom use , but depression undercuts the prevention benefits of ART , highlighting the need to integrate mental health services into HIV care Child sexual abuse ( CSA ) is associated with HIV risk behaviors [ Bensley , L. , Van Eenwyk , J. , and Simmons , K. W. , 2003 . ] and more prevalent among women living with HIV than in the general population [ Koenig , L. J. , and Clark , H. , 2004 ] . This r and omized Phase ~ I clinical trial tested the impact of a culturally congruent psychoeducational intervention design ed to reduce sexual risks  and increase  HIV medication adherence for HIV-positive women with CSA histories . An ethnically diverse sample of 147 women were r and omized to two conditions : an 11-session Enhanced Sexual Health Intervention ( ESHI ) or an attention control . Results based on “ intent to treat ’ ’ analysesof pre – post changes are reported here . Additional analyses explored whether theobserved effects might depend on “ intervention dose , ’ ’ i.e. , number of sessions attended . Women in the ESHI condition reported greater sexual risk reduction than women in the control condition . Although there were no differences between women in the ESHI and control groups on medication adherence , women in the ESHI condition who attended 8 or more sessions reported greater medication adherence at posttest than control women . The findings provide initial support for this culturally and gender-congruent psychoeducational intervention for HIV-positive women with CSA , and highlight the importance of addressing the effects of CSA on sexual risk reduction and medicationadherence in preventive interventions for women Background : Nearly perfect compliance seems to be indispensable to obtain the maximum benefit from highly active antiretroviral therapy ( HAART ) . Interventions to ensure a high level of adherence during a relatively long‐term period of therapy are necessary . Methods : This is a prospect i ve , r and omized , two‐arm controlled study including patients starting their first‐ or second‐line HAART who were r and omized to receive psychoeducative intervention to implement adherence ( experimental group [ EG ] ) or a usual medical follow‐up ( control group [ CG ] ) 
    Output:
    
The overall effect size indicates a small to moderate positive effect ( Hedges ' g = 0.37 ) of psychosocial interventions on medication adherence in people living with HIV .
No evidence for publication bias was found .
This meta- analysis study concludes that various psychosocial interventions can improve medication adherence and thereby the health of people living with HIV