***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 evaluated a nurse-delivered adherence intervention in a preliminary r and omized controlled trial among 70 HIV-positive out patients initiating antiretroviral therapy ( ART ) in Beijing , China . In both arms , participants received a 30-min educational session , a pillbox , and a referral to a peer support group . In the enhanced arm , participants could choose an electronic reminder device , three sessions of counseling either alone or with a treatment adherence partner , or both reminder and counseling .  Survey assessment s and blood draws occurred at baseline , post-intervention ( 13 weeks ) , and follow-up ( 25 weeks ) . Primary outcomes were 7-day and 30-day adherence assessed by self-report and electronic drug monitoring ( EDM ) , and secondary outcomes were HIV-1 RNA viral load and CD4 count . The intervention was feasible and well received . It led to some improvement in self-reported and EDM-assessed adherence but not the biological outcomes . Providing counseling and facilitating the use of electronic reminders to patients initiating ART merits further investigation as a culturally viable means of promoting adherence in China Food insecurity and malnutrition negatively affect adherence to antiretroviral therapy ( ART ) and are associated with poor HIV clinical outcomes . We examined the effect of providing household food assistance and nutrition education on ART adherence . A 12-month prospect i ve clinical trial compared the effect of a monthly household food basket ( FB ) plus nutrition education ( NE ) versus NE alone on ART adherence on 400 HIV patients at four clinics in Honduras . Participants had been receiving ART for an average of 3.7 years and were selected because they had suboptimal adherence . Primary outcome measures were missed clinic appointments , delayed prescription refills , and self-reported missed doses of ART . These three adherence measures improved for both groups over 12 months ( p < 0.01 ) , mostly within 6 months . On-time prescription refills improved for the FB plus NE group by 19.6 % more than the group receiving NE alone after 6 months ( p < 0.01 ) , with no further change at 12 months . Change in missed appointments and self-reported missed ART doses did not significantly differ by intervention group . ResumenLa inseguridad alimentaria y la malnutrición afectan en forma negativa la adherencia a la terapia antiretroviral ( TAR ) , y se asocian con malos result ados clínicos relacionados con el VIH . En este estudio examinamos el efecto de ofrecer una canasta de ayuda alimentaria ( CA ) y educación nutricional ( EN ) sobre la adherencia a la TAR . Mediante un ensayo clínico prospect ivo a nivel de conglomerados , comparamos el efecto de una CA para la familia ofrecida en forma mensual adicional a EN en contraste con EN por sí sola sobre la adherencia a la TAR en 400 pacientes infectados con VIH , en cuatro clínicas en Honduras . Los participantes habían estado recibiendo TAR por un promedio de 3.7 años , y fueron elegidos con base en mostrar adherencia sub-óptima a la misma . Las medidas de impacto incluyeron número de citas clínicas perdidas , retraso en surtir los medicamentos , y el auto-reporte de dosis faltantes de TAR . Las tres medidas mejoraron en ambos grupos a lo largo de 12 meses de seguimiento ( p < 0.01 ) , con la mayor parte del efecto observado en los primeros 6 meses . El surtimiento de medicamentos en la farmacia mejoró 19.6 % más en el grupo que recibió CA más EN en comparación con el grupo que recibió sólo EN , a los 6 meses de seguimiento ( p < 0.01 ) , sin mayor cambio a los 12 meses de seguimiento . En cuanto a citas clínicas perdidas y el auto-reporte de dosis faltantes de TAR , no hubo una diferencia significativa al comparar entre ambos grupos 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 In developing countries , access to antiretroviral treatment for persons living with HIV is still in progress . Malnutrition represents another cause of acquired immunodeficiency and premature death . This evaluation program estimated the impact of family nutritional support during the first year of antiretroviral treatment in West Africa 's sub-Sahara region .  Family nutritional support was proposed to patients with CD-4 cell count < 200 /mm3 and /or developing a WHO stage III/IV or with body mass index < 18.5 kg/m2 and receiving antiretroviral treatment . Follow-up of 62 patients receiving support was compared to 118 patients who had only received antiretroviral treatment the year before .  Average body mass index , CD-4 cell count were 20.7 and 20.5 , 217 and 191/mm3 respectively in supported and control groups ( NS ) . Twenty-two ( 36 % ) and 56 ( 48 % ) were WHO stage III/IV ( NS ) respectively in supported and control groups . One patient who received support and twelve controls died ( Mortality Ratio=0.19 ; p<0.05 ) . Increase in CD-4 cell count was around 1.7 times higher ( + 114 vs. + 68 CD-4 cells/mm3 respectively in supported and control groups ; p<0.05 ) and observance was improved in supported group ( p<0.005 ) . The evolutions of WHO stage and body mass index were not different but the study period was short . Family nutritional support for persons living with HIV initiating antiretroviral treatment in a developing country showed a positive impact after six months . This family intervention could be integrated into AIDS interventions as an effective and comprehensive community-based primary care BACKGROUND Minimizing death and ensuring high retention and good adherence remain ongoing challenges for human immunodeficiency virus ( HIV ) treatment programs . We examined whether the addition of community-based accompaniment ( characterized by daily home visits from a community health worker , directly observed treatment , nutritional support , transportation stipends , and other support as needed ) to the Rw and a national model for antiretroviral therapy ( ART ) delivery would improve retention in care , viral load suppression , and change in CD4 count , relative to the national model alone . METHODS We conducted a prospect i ve observational cohort study among 610 HIV-infected adults initiating ART in 1 of 2 programs in rural Rw and a. Psychosocial and clinical characteristics were recorded at ART initiation . Death , treatment retention , and plasma viral load were assessed at 1 year . CD4 count was evaluated at 6-month intervals . Multivariable regression models were used to adjust for baseline differences between the 2 population s. RESULTS Eighty-five percent and 79 % of participants in the community-based and clinic-based programs , respectively , were retained with viral load suppression at 1 year . After adjusting for CD4 count , depression , physical health quality of life , and food insecurity , community-based accompaniment was protective against death or loss to follow-up during the first year of ART ( hazard ratio , 0.17 ; 95 % confidence interval [ CI ] , .09-.35 ; P < .0001 ) . In a second multivariable analysis , individuals receiving accompaniment were more likely to be retained with a suppressed viral load at 1 year ( risk ratio : 1.15 ; 95 % CI , 1.03 - 1.27 ; P = .01 ) . CONCLUSIONS These findings indicate that community-based accompaniment is effective in improving retention , when added to a clinic-based program with fewer patient support mechanisms Background : This pilot study evaluated an intervention design ed to enhance adherence among those new to antiretroviral therapy . Methods : Participants ( n = 80 ) were recruited from a hospital clinic in Ch and igarh , India , and r and omized to a 3-month group intervention or individual enhanced st and ard of care followed by crossover of condition and assessed over 6 months .  Adherence was measured by prescription refill , pill count , and self-report . Results : At baseline , 56 % of group condition ( immediate intervention ) and 54 % of individual condition ( delayed intervention ) participants were nonadherent by pill count and 23 % of group and 26 % of individual condition participants self-reported skipping medication at least once over the last 3 months . From the postintervention to long-term follow-up , adherence in the group condition ( immediate intervention ) improved in comparison with adherence in the individual condition ( delayed intervention ; χ2 = 5.67 , P = .02 ) . Conclusions : Results support the use of interventions early in treatment to provide information and social support to establish long-term healthy adherence behaviors A pilot study was conducted to determine effects of an empowerment intervention on antiretroviral therapy ( ART ) adherence among Thai youth living with HIV/AIDS . It compared two groups of 23 young persons ( 15–24 years ) who receive ART from AIDS clinics at two community hospitals . One hospital 's patients served as the experimental group , and the other as a control group . The experimental groups attended five sessions that empowered them to take control of their own health . The control group received the st and ard of care . The data were analyzed using descriptive statistics and Chi-square statistics . Before the empowerment , no one from the experimental group or the control group had ART adherence ≥ 95 % . After the intervention , the 82.6 % of the experimental group had ≥ 95 % adherence compared to the control group , which had 21.7 % adherence ( p < .0001 ) . The empowerment intervention result ed in a significant increase in ART adherence among Thai youth 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 
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However , task shifting , community-based adherence support , mHealth platforms , and group adherence counseling emerged as strategies used in adult population s that show promise for adaptation and testing among adolescents .
Conclusions Despite the sizeable body of evidence for adults , few studies were high quality and no single intervention strategy stood out as definitively warranting adaptation for adolescents .