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Table 6 Summary of findings comparison 2

From: Self-management interventions for adolescents living with HIV: a systematic review

Summary of findings: Self-management interventions compared to control in adolescents living with HIV

Patient or population: Adolescents living with HIV; Setting: Low-, middle-, and high-income countries; Intervention: Self-management interventions with all 3 components; Comparison: Usual care

Outcome

Follow-up

Pooled effect (95%CI)

No. of participants (studies)

Certainty of evidence (GRADE)

Comments

Confidence

6 months

MD 0.80 (−0.12 to 1.72)

93 (1 trial)

⨁◯◯◯

VERY LOW a,b,c

HIV self-management interventions compared to usual care for adolescents living with HIV may make little or no difference to confidence at 6-month follow-up, but the evidence is very uncertain.

Adherence (self-reported)

6 months

SMD 0.67 (0.27 to 1.07)

107 (2 trials)

⨁◯◯◯

VERY LOW a,b,c

HIV self-management interventions compared to usual care for adolescents living with HIV may increase self-reported adherence at 6-month follow-up, but the evidence is very uncertain.

Adherence (more than 95%)

9 months

RR 1.14 (1.20 to 1.65)

177 (1 trial)

⨁◯◯◯

VERY LOW a,b,c

HIV self-management interventions compared to usual care for adolescents living with HIV may increase the likelihood of achieving over 95% adherence at 9-month follow-up, but the evidence is very uncertain.

Sexual risk behaviour

3 months

MD −11.97 (−25.45 to 1.51)

51 (1 trial)

⨁◯◯◯

VERY LOW a,b,c

HIV self-management interventions compared to usual care for adolescents living with HIV may make little or no difference to sexual risk behaviour at 3-month follow-up, but the evidence is very uncertain.

Viral load (log 10)

3 months

MD −0.66 (−1.21 to − 0.11)

51 (1 trial)

⨁◯◯◯

VERY LOW a,b,c

HIV self-management interventions compared to usual care for adolescents living with HIV may decrease viral load at 3-month follow-up and may make little to no difference at 6-month follow-up, but the evidence is very uncertain.

6 months

MD −0.84 (−1.69 to 0.01)

93 (1 trial)

Depression

6 months

MD −0.60

(−2.67 to 1.47)

93

(1 trial)

⨁◯◯◯

VERY LOW a,b,c

HIV self-management interventions compared to usual care for adolescents living with HIV may make little or no difference to depression at 6-month follow-up, but the evidence is very uncertain.

  1. CI Confidence interval, MD Mean difference, SMD Standardised mean difference, RR Risk ratio
  2. GRADE Working Group: Grades of evidence
  3. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.
  4. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
  5. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
  6. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.
  7. Footnotes: Explanation of GRADE certainty of evidence
  8. a Downgraded by 1 for serious concerns about risk of bias in at least one domain
  9. b Downgraded by 1 for indirectness, as studies did not only include adolescents (age 10 to 19)
  10. c Downgraded by 1 for serious concerns about imprecision with wide 95%CI intervals and small sample sizes
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BMC Infectious Diseases

ISSN: 1471-2334

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