Behavioral and cognitive interventions to improve treatment adherence and access to HIV care among older adults in sub-Saharan Africa: an updated systematic review

BACKGROUND: Approximately 14% of Africans infected with HIV are over the age of 50, yet few intervention studies focus on improving access to care, retention in care, and adherence to antiretroviral therapy (ART) in this population. A review of the published literature until 2012, found no relevant ART management and care interventions for older people living with HIV (OPLHIV) in sub-Saharan Africa. The aim of this systematic review is to update the original systematic review of intervention studies on OPLHIV, with a focus on evidence from sub-Saharan Africa. METHODS: We conducted a systematic review of the available published literature from 2012 to 2017 to explore behavioral and cognitive interventions addressing access to ART, retention in HIV care and adherence to ART in sub-Saharan Africa that include older adults (50+). We searched three databases (MEDLINE, EMBASE, and Education Resources Information Center) using relevant Medical Subject Headings (MeSH) terms as well as a manual search of the reference lists. No language restrictions were placed. We identified eight articles which were analyzed using content analysis with additional information obtained directly from the corresponding authors. RESULTS AND DISCUSSION: There were no studies that exclusively focused on OPLHIV. Three studies referred only to participants being over 18 years and did not specify age categories. Therefore, it is unclear whether these studies actively considered people living with HIV over the age of 50. Although the studies sampled older adults, they lacked sufficient data to draw conclusions about the relevance of the outcomes of this group. CONCLUSIONS: These findings underscore the need to increase the evidence-base of which interventions will work for older Africans on ART

Mortality and treatment response amongst HIV-infected patients 50 years and older accessing antiretroviral services in South Africa.

CAPRISA, 2018.Abstract available in pdf

Social Contingencies and College Quit and Win Contest: A Qualitative Inquiry

OBJECTIVES: To investigate the social contingencies associated with participation in a college Quit and Win contest to promote smoking cessation. METHODS: Six focus groups (N = 27)were conducted with college students who participated in a Quit and Win research trial. RESULTS: Themes included: 1) participants reluctant to disclose quit decision; 2) perception of little support in their quit attempt, and 3) the social environment as a trigger for relapse. CONCLUSION: Although Quit and Win contests appear to motivate an initial quit attempt, the reluctance of smokers to disclose their quit attempt limits the potential positive impact of social support when utilizing this public service campaign