***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: AIMS AND OBJECTIVES This study aim ed to examine the effects of nurse-delivered home visits combined with telephone intervention on medication adherence , and quality of life in HIV-infected heroin users . BACKGROUND Drug use is consistently reported as a risk factor for medication non-adherence in HIV-infected people . DESIGN An experimental , pretests and post-tests , design was used : baseline and at eight months . METHODS A sample of 116 participants was recruited from three antiretroviral treatment sites , and 98 participants completed the study . They were r and omly assigned to two groups : 58 in the experimental group and 58 in the control group . The experimental group received nurse-delivered home visits combined with telephone intervention over eight months , while the control group only received routine care . The question naire of Community Programs for Clinical Research on AIDS ( CPCRA ) Antiretroviral Medication Self-Report was used to assess levels of adherence , while quality of life and depression were evaluated using Chinese versions of World Health Organization Quality of Life Instrument-Abbreviated version ( WHOQOL-BREF ) and Self-rating Depression Scale , respectively . Data were obtained at baseline and eight months . RESULTS At the end of eight months , participants in the experimental group were more likely to report taking 100 % of pills ( Fisher 's exact = 14.3 , p = 0.0001 ) and taking pills on time ( Fisher 's exact = 18.64 , p = 0.0001 ) than those in the control group . There were significant effects of intervention in physical ( F = 10.47 , p = 0.002 ) , psychological ( F = 9.41 , p = 0.003 ) , social ( F = 4.09 , p = 0.046 ) and environmental ( F = 4.80 , p = 0.031 ) domains of WHOQOL and depression ( F = 5.58 , p = 0.02 ) . CONCLUSIONS Home visits and telephone calls are effective in promoting adherence to antiretroviral treatment and in improving the participants ' quality of life and depressive symptoms  in HIV-infected heroin users . RELEVANCE TO CLINICAL PRACTICE It is important for nurses to recognise the issues of non-adherence to antiretroviral treatment in heroin users . Besides st and ard care , nurses should consider conducting home visits and telephone calls to ensure better health outcome of antiretroviral treatment in this population Abstract A r and om sample of 271 people living with HIV ( PLWH ) who were former plasma/blood donors and a convenience sample of 67 HIV negative villagers were anonymously interviewed . Compared with the non-PLWH , PLWH reported higher prevalence of symptoms of depression ( adjusted OR = 2.53 , p=0.001 ) , anxiety ( adjusted OR = 1.85 , p=0.04 ) , and stress ( adjusted OR = 1.77 , p=0.06 ) . Of the PLWH respondents , 81.7 % received Highly Active Antiretroviral Therapy ( HAART ) ; 32.1 % of whom reported some side effects . Respectively 13.7 % , 37.4 % , and 38.4 % PLWH perceived discrimination from their family members , relatives/friends , and neighbors . Absence of HAART , poor physical function , perceived discrimination from relatives and friends , and low level of resilience were associated with depression ( stepwise regression ; β = − 0.28–0.17 , R-square = 0.22 ) , anxiety and stress ( R-square = 0.32 and 0.16 , respectively ) . The majority of respondents ( 70.1 % ) desired group intervention as a means for providing psychological support services . Relevant programs should both remove risk factors ( e.g. , absence of medical treatment , HIV-related discrimination ) and promote protective factors ( e.g. , resilience ) . Support group is one of the potentially useful approaches to provide psychological support services Two-thirds of those with HIV worldwide live in sub-Saharan Africa . Alcohol use is associated with the HIV epidemic through risky sex and suboptimal ARV adherence . In western Kenya , hazardous drinking was reported by HIV ( 53 % ) and general medicine ( 68 % ) out patients .  Cognitive behavioral treatment ( CBT ) has demonstrated strong efficacy to reduce alcohol use . This article reports on a systematic cultural adaptation and pilot feasibility study of group paraprofessional-delivered CBT to reduce alcohol use among HIV-infected out patients in Eldoret , Kenya . Following adaptation and counselor training , five pilot groups were run ( n = 27 ) . Overall attendance was 77 % . Percent days abstinent from alcohol ( PDA ) before session 1 was 52–100 % ( women ) and 21–36 % ( men ) , and by session 6 was 96–100 % ( women ) and 89–100 % ( men ) . PDA effect sizes ( Cohen ’s d ) between first and last CBT session were 2.32 ( women ) and 2.64 ( men ) . Participants reported treatment satisfaction . Results indicate feasibility , acceptability and preliminary efficacy for CBT in Kenya BACKGROUND Psychiatric disorders in HIV/AIDS are common , emerging soon after diagnosis or during the subsequent course of illness . However , there are few prospect i ve studies on the rates of psychiatric disorders in HIV/AIDS , particularly in the context of the developing world . METHODS Sixty-five patients with recently diagnosed HIV were interviewed on presentation to a hospital-based HIV clinic and then 6 months later . On both interviews , the patients were assessed using the  MINI International Neuropsychiatric Interview , the Carver Brief COPE , and the Sheehan Disability Scale . Exposure to negative life events and risk behaviors  was also evaluated . RESULTS The overall prevalence of psychiatric disorders in the follow-up period remained high ( 56 % of patients had at least one psychiatric disorder at baseline , and 48 % of patients had at least one psychiatric disorder at 6 months ) . Depression and posttraumatic stress disorder ( PTSD ) were the most prevalent disorders at both baseline ( 34.9 % and 14.8 % ) and follow-up ( 26 % and 20 % ) , respectively . More than half of all patients with depression at baseline improved ( 16 of 29 ; 55.1 % ) . However , there was a new onset of both depression ( 4 of 49 ; 8.1 % ) and PTSD ( 12 of 17 ; 70.5 % ) on follow-up . In univariate analysis , depression on follow-up was significantly associated with : ( a ) disability in work/social/family functioning , ( b ) greater number of negative life events , and ( c ) a decline in CD4 lymphocyte count . Univariate analysis also revealed that a diagnosis of PTSD on follow-up was significantly associated with ( a ) a longer duration of infection and ( b ) baseline disability in work/social/family functioning . However , in multivariate analysis , only disability scores predicted the diagnoses of major depression and PTSD on follow-up assessment . Persistence of risky sexual behaviour was also noted , with a significantly higher number of participants reporting nonuse of condom on follow-up . There appeared to be a shift from maladaptive coping behaviors to more adaptive coping behaviors over the 6-month period . CONCLUSION The rate of psychiatric disorders in HIV/AIDS patients was consistent over time . These findings emphasize the importance of regular evaluation for psychiatric disorders in HIV/AIDS patients , not only at the commencement of treatment but also during subsequent follow-up visits Background The devastating impact of AIDS in the world especially in sub-Saharan Africa has led to an unprecedented global effort to ensure access to antiretroviral ( ARV ) drugs . Given that medication-taking behavior can immensely affect an individual 's response ; ART adherence is now widely recognized as an ' Achilles heel ' for the successful outcome . The present study was undertaken to investigate the rate and predictors of adherence to antiretroviral therapy among HIV-infected persons in southwest Ethiopia . Methods The study was conducted in the antiretroviral therapy unit of Jimma University Specialized Hospital . A prospect i ve study was undertaken on a total of 400 HIV infected person . Data were collected using a pre-tested interviewer-administered structured question naire at first month ( M0 ) and third month ( M3 ) follow up visits . Results A total of 400 and 383 patients at baseline ( M0 ) and at follow up visit ( M3 ) respectively were interviewed . Self-reported dose adherence in the study area was 94.3 % . The rate considering the combined indicator ( dose , time and food ) was 75.7 % . Within a three month follow up period , dose adherence decreased by 2 % and overall adherence rate decreased by more than 3 % . Adherence was common in those patients who have a social support ( OR , 1.82 , 95%CI , 1.04 , 3.21 ) . Patients who were not depressed were two times more likely to be adherent than those who were depressed ( OR , 2.13 , 95%CI , 1.18 , 3.81 ) . However , at the follow up visit , social support ( OR , 2.42 , 95%CI , 1.29 , 4.55 ) and the use of memory aids ( OR , 3.29 , 95%CI , 1.44 , 7.51 ) were found to be independent predictors of adherence . The principal reasons reported for skipping doses in this study were simply forgetting , feeling sick or ill , being busy and running out of medication in more than 75 % of the cases . Conclusion The self reported adherence rate was high in the study area . The study showed that adherence is a dynamic process which changes overtime and can not reliably be predicted by a few patient characteristics that are assumed to vary with time . Adherence is a process , not a single event , and adherence support should be integrated into regular clinical follow up Objective : To examine the effect of a 15-session individually delivered cognitive behavioral intervention on antiretroviral ( ART ) medication adherence . Design : A multisite , 2-group , r and omized controlled trial . Participants : Two hundred four HIV-infected participants with self-reported ART adherence < 85 % from a total of 3818 participants screened were r and omized into the trial . Potential participants were recruited for the main trial based on sexual risk criteria in Los Angeles , Milwaukee , New York , and San Francisco . Intervention : The primary outcome of the intervention was a reduction in HIV transmission risk behaviors . Fifteen 90-minute individually delivered sessions were divided into 3 modules : Stress , Coping , and Adjustment ; Safer Behaviors ; and Health Behaviors , including an emphasis on ART adherence . Controls received no intervention until trial completion . Both groups completed follow-up assessment s at 5 , 10 , 15 , 20 , and 25 months after r and omization . Main Outcome Measure : Self-reported ART adherence as measured by 3-day computerized assessment . Results : A significance difference in rates of reported adherence was observed between intervention and control participants at months 5 and 15 , corresponding to the assessment s after the Stress , Coping , and Adjustment module ( 5-month time point ) and after the Health Behaviors module ( 15-month time point ) . The relative improvements among the intervention group compared with the control group dissipated at follow-up . Conclusions : Cognitive behavioral intervention programs may effectively improve ART adherence , but the effects of intervention may be short-lived The effects of alcohol abuse on HIV disease progression have not been definitively established . A prospect i ve , 30-month , longitudinal study of 231 HIV(+ ) adults included history of alcohol and illicit drug use , adherence to antiretroviral therapy ( ART ) , CD4(+ ) cell count , and HIV viral load every 6 months .  Frequent alcohol users ( two or more drinks daily ) were 2.91 times ( 95 % CI : 1.23 - 6.85 , p = 0.015 ) more likely to present a decline of CD4 to < or=200 cells/microl , independent of baseline CD4(+ ) cell count and HIV viral load , antiretroviral use over time , time since HIV diagnosis , age , and gender . Frequent alcohol users who were not on ART also increased their risk for CD4 cell decline to < or=200 cells/mm(3 ) ( HR = 7.76 : 95 % CI : 1.2 - 49.2 , p = 0.03 ) . Combined frequent alcohol use with crack-cocaine showed a significant risk of CD4(+ ) cell decline ( HR = 3.57 : 95 % CI : 1.24 - 10.31 , p = 0.018 ) . Frequent alcohol intake was associated with higher viral load over time ( beta = 0.259 , p = 0.038 ) . This significance was maintained in those receiving ART ( beta = 0.384 , p = 0.0457 ) , but not in those without ART . Frequent alcohol intake and the combination of frequent alcohol and crack-cocaine accelerate HIV disease progression . The effect of alcohol on CD4(+ ) cell decline appears to be independent of 
    Output:
    
RESULTS This review found ample and moderately consistent evidence that adverse mental health and alcohol consumption are associated with reduced adherence .
This review suggests that psychosocial factors , namely , depression and alcohol may have adverse effects upon HIV-related outcomes .