***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: This r and omized behavioral trial examined whether youth living with HIV ( YLH ) receiving cell-phone support with study funded phone plans , demonstrated improved adherence and viral control during the 24 week intervention and 24 weeks post-intervention compared to controls . Monday through Friday phone calls confirmed medications were taken , provided problem-solving support , and referred to services to address adherence barriers . Of 37 participants ( ages 15–24 ) , 62 % were male and 70 % were African American .  Self-reported adherence was significantly higher in the intervention group compared to the control at 24 and 48 weeks for the past month ( P = 0.007 ) and log 10 HIV VL was significantly lower at both 24 weeks ( 2.82 versus 4.52 P = 0.002 ) and 48 weeks ( 3.23 versus 4.23 P = 0.043 ) . Adherence and viral load showed medium to large effect sizes across the 48 week study . This is the first study to demonstrate sustained clinical ly significant reductions in HIV VL using youth friendly technology . ResumenEste ensayo de comportamiento aleatorio examinó si los jóvenes que viven con el VIH ( YLH ) reciben apoyo por celular con el estudio financiado de teléfono , se demostró un mejor cumplimiento y control viral durante la intervención de 24 semanas y 24 semanas después de la intervención en comparación con los controles . De Lunes a Viernes las llamadas telefónicas confirmaron los medicamentos , apoyaron la resolución de problemas , y se refirió a los servicios para hacer frente a las barreras de adherencia . De los 37 participantes ( siglos 15–24 ) , el 62 % eran hombres y el 70 % eran afroamericanos . Adherencia auto-reportada fue significativamente mayor en el grupo de intervención en comparación con el control a las 24 y 48 semanas del mes pasado ( P = 0.007 ) y el log 10 VL VIH fue significativamente menor en ambos 24 semanas ( 2.82 versus 4.52 P = 0.002 ) y 48 semanas ( 3.23 versus 4.23 P = 0.043 ) . La adhesión y la carga viral mostraron medianas y gr and es tamaños del efecto en todo el estudio de 48 semanas . Este es el primer estudio que demuestra descensos importantes de la VL VIH utiliz and o tecnología amigable para la juventud This pilot r and omized controlled trial evaluated a previously developed manualized telephone based cognitive behavioral therapy ( T-CBT ) intervention compared to face-to-face ( f2f ) therapy among low-income , urban dwelling HIV infected depressed individuals . The primary outcome was the reduction of depressive symptoms as measured by the Hamliton rating scale for depression scale . The secondary outcome was adherence to HAART as measured by r and om telephone based pill counts . Outcome measures were collected by trained research assistants masked to treatment allocation . Analysis was based on intention-to-treat . Thirty-four participants met eligibility criteria and were r and omly assigned to receive T-CBT ( n = 16 ) or f2f ( n = 18 ) . There was no statistically significant difference in depression treatment outcomes comparing f2f to T-CBT . Within group evaluation demonstrated that both the T-CBT and the f2f psychotherapy groups result ed in significant reductions in depressive symptoms . Those who received the T-CBT were significantly more likely to maintain their adherence to antiretroviral medication compared to the f2f treatment . None of the participants discontinued treatment due to adverse events . T-CBT can be delivered to low-income , urban dwelling HIV infected depressed individuals result ing in significant reductions in depression symptoms and improved adherence to antiretroviral medication . Trial Registry : Clinical Trial.gov identifier : NCT01055158 We evaluated the efficacy of LifeWindows , a theory-based , computer-administered antiretroviral ( ARV ) therapy adherence support intervention , delivered to HIV + patients at routine clinical care visits . 594 HIV + adults receiving HIV care at five clinics were r and omized to intervention or control arms . Intervention vs. control impact in the intent-to-treat sample ( including participants whose ARVs had been entirely discontinued , who infrequently attended care , or infrequently used LifeWindows ) did not reach significance . Intervention impact in the On Protocol sample ( 328 intervention and control arm participants whose ARVs were not discontinued , who attended care and were exposed to LifeWindows regularly ) was significant . On Protocol intervention vs. control participants achieved significantly higher levels of perfect 3-day ACTG-assessed adherence over time , with sensitivity analyses maintaining this effect down to 70 % adherence . This study supports the utility of LifeWindows and illustrates that patients on ARVs who persist in care at clinical care sites can benefit from adherence promotion software . ResumenEvaluamos la eficacia de LifeWindows , una intervención de apoyo para la adherencia a la terapia antirretroviral ( TAR ) basada en teoría y con administración informatizada para pacientes con VIH + en sus visitas clínicas rutinarias . 594 adultos de cinco clínicas con VIH + y bajo tratamiento fueron aleatoriamente asignados a un grupo de intervención o de control . No se alcanzó significación estadística al comparar ambos grupos bajo la estrategia de ‘ intención de tratar ’ ( incluyendo los participantes cuyos TAR se habían interrumpido por completo , habían asistido a la clínica en pocas ocasiones , o usaron LifeWindows con poca frecuencia ) . Sin embargo , la intervención obtuvo un impacto significativo cu and o se evaluó con la muestra bajo Protocol o ( un total de 328 participantes cuyos TAR no fueron interrumpidos , asistieron a sus visitas clínicas y se expusieron a LifeWindows regularmente ) . Los participantes bajo Protocol o de intervención obtuvieron niveles más altos de adherencia que el grupo control en tres días de Estudios de Grupos Clinicos con SIDA ( EGCS ) con repetidas evaluaciones y manteniendo como mínimo un 70 % de la adherencia . Este estudio apoya la utilidad de LifeWindows e indica que los pacientes con TAR que asisten a las visitas clínicas , pueden beneficiarse de este software de promoción de la adherencia The prevalence of AIDS is five times higher among prison inmates than in the general population . Because recidivism is common and many inmates are serving short sentences for parole violation , HIV-seropositive inmates move frequently between prison and their home communities . We design ed an eight-session prerelease intervention for HIV seropositive inmates to decrease sexual and drug-related risk behavior and to increase use of community re sources after release . The intervention sessions were delivered at the prison by community service providers . We found that a prerelease  risk reduction intervention for HIV seropositive inmates was feasible . Descriptive results support the effectiveness of the program in reducing sexual and drug-related behaviors and in increasing use of community re sources after release . Compared with men who signed up for the intervention but were unable to attend , men who received the intervention reported more use of community re sources and less sexual and drug-related risk behavior in the months following release . We recommend dissemination and continued evaluation of this risk-reduction intervention Adherence to antiretroviral therapy ( ART ) represents one of the strongest predictors of progression to AIDS , yet it is difficult for most patients to sustain high levels of adherence . This study compares the efficacy of a personalized cell phone reminder system ( ARemind ) in enhancing adherence to ART versus a beeper .  Twenty-three HIV-infected subjects on ART with self-reported adherence less than 85 % were r and omized to a cellular phone ( CP ) or beeper ( BP ) . CP subjects received personalized text messages daily ; in contrast , BP subjects received a reminder beep at the time of dosing . Interviews were scheduled at weeks 3 and 6 . Adherence to ART was measured by self-report ( SR , 7-day recall ) , pill count ( PC , past 30 days at baseline , then past 3 weeks ) , Medication Event Monitoring System ( MEMS ; cumulatively at 3 and 6 weeks ) , and via a composite adherence score constructed by combining MEMS , pill count , and self report . A mixed effects model adjusting for baseline adherence was used to compare adherence rates between the intervention groups at 3 and 6 weeks . Nineteen subjects completed all visits , 10 men and 9 females . The mean age was 42.7 ± 6.5 years , 37 % of subjects were Caucasian and 89 % acquired HIV heterosexually .  The average adherence to ART was 79 % by SR and 65 % by PC at baseline in both arms ; over 6 weeks adherence increased and remained significantly higher in the ARemind group using multiple measures of adherence . A larger and longer prospect i ve study is needed to confirm these findings and to better underst and optimal reminder messages and user fatigue Objectives : To examine the effect of a 15-session coping group intervention compared with a 15-session therapeutic support group intervention among HIV-positive men and women with a history of childhood sexual abuse ( CSA ) on sexual transmission risk behavior . Design : A r and omized controlled behavioral intervention trial with 12-month follow-up . Methods : A diverse sample of 247 HIV-positive men and women with histories of CSA was r and omized to 1 of 2 time-matched group intervention conditions . Sexual behavior was assessed at baseline ; immediately after the intervention ; and at 4- , 8- , and 12-month follow-up periods ( 5 assessment s ) . Changes in frequency of unprotected anal and vaginal intercourse by intervention condition were examined using generalized linear mixed models for all partners , and specifically for HIV-negative or serostatus unknown partners . Results : Participants in the HIV and trauma coping intervention condition decreased their frequency of unprotected sexual intercourse more than participants in the support intervention condition for all partners ( P < 0.001 ; d = 0.38 , 0.32 , and 0.38 at the 4- , 8- , and 12-month follow-up periods , respectively ) and for HIV-negative and serostatus unknown partners ( P < 0.001 ; d = 0.48 , 0.39 , and 0.04 at the 4- , 8- , and 12-month follow-up periods , respectively ) . Conclusion : A group intervention to address coping with HIV and CSA can be effective in reducing transmission risk behavior among HIV-positive men and women with histories of sexual trauma Background Data regarding the efficacy of directly administered antiretroviral therapy ( DAART ) are mixed . Opioid treatment programs ( OTPs ) provide a convenient framework for DAART . In a r and omized controlled trial , we compared DAART and self-administered therapy ( SAT ) among HIV-infected subjects attending five OTPs in Baltimore , MD . Methods HIV-infected individuals attending OTPs were eligible if they were not taking antiretroviral therapy ( ART ) or were virologically failing ART at last clinical assessment . In subjects assigned to DAART , we observed one ART dose per weekday at the OTP for up to 12 months . SAT subjects administered ART at home . The primary efficacy comparison was the between-arm difference in the average proportions with HIV RNA < 50 copies/mL during the intervention phase ( 3- , 6- , and 12-month study visits ) , using a logistic regression model accounting for intra-person correlation due to repeated observations . Adherence was measured with electronic monitors in both arms . Results We r and omized 55 and 52 subjects from five Baltimore OTPs to DAART and SAT , respectively . The average proportions with HIV RNA < 50 copies/mL during the intervention phase were 0.51 in DAART and 0.40 in SAT ( difference 0.11 , 95 % CI : −0.020 to 0.24 ) . There were no significant differences between arms in electronically-measured adherence , average CD4 cell increase from baseline , average change in log10 HIV RNA from baseline , opportunistic conditions , hospitalizations , mortality , or the development of new drug resistance mutations . Conclusions In this r and omized trial , we found little evidence that DAART provided clinical benefits compared to SAT among HIV-infected subjects attending OTPs . Trial Registration Clinical Trails.gov NCT00279110 NCT00279110?term = NCT00279110&rank = HIV+ inmates reentering their communities are at increased risk for poor health outcomes and for transmitting HIV . This article reports on a r and omized trial comparing an ecosystem-based intervention and an individually focused intervention for reducing HIV transmission risk and improving medication adherence . Reincarceration was considered as a secondary variable . Both groups decreased sexual risk behavior over the 12-month follow-up period . Unexpectedly , the ecosystem intervention group was less likely to be taking medication or to be adherent and more likely to have been reincarcerated . Failure to demonstrate a significant advantage of the ecosystem intervention may have result ed from the difficulty of engaging family and other ecosystem members in the intervention . Implication s for developing and applying interventions for this population are discussed Nurses at the Well-Being Institute , a community-based nursing outreach clinic in Detroit , Michigan , located 75 women living with HIV , mental illness , and substance abuse who were lost to follow-up at their 
    Output:
    
Integrated interventions produced some favorable prevention and care continuum outcomes in PLWH .