Recent Advances (2011-2012) in Technology-Delivered Interventions for People Living with HIV
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BEHAVIORAL ASPECTS OF HIV MANAGEMENT (RJ DICLEMENTE AND JL BROWN, SECTION EDITORS)
Recent Advances (2011-2012) in Technology-Delivered Interventions for People Living with HIV Jennifer A. Pellowski & Seth C. Kalichman
Published online: 26 August 2012 # Springer Science+Business Media, LLC 2012
Abstract Technology is rapidly advancing and becoming a cost effective option for intervention delivery particularly for isolated and hard to reach populations, such as people living with HIV/AIDS. A systematic review was conducted to identify recent technology based interventions for people living with HIV. The review yielded 12 studies that were grouped by the health behavior that it addressed and then the type of technology utilized. The majority of studies reviewed focused on medication adherence and used several different technologies to deliver the intervention including SMS/text messaging, cell phones and computers. This review identified several gaps in the literature particularly the lack of technology-based interventions focusing on engagement and retention to care as well as sexual risk reduction. Suggestions for future research based on these findings are provided. Keywords HIV/AIDS . HIV management . Technology . Technology intervention . Technology-based intervention . Secondary prevention . Systematic review . Sexual risk reduction . People living with HIV (PLWH)
Introduction There are an estimated 33.3 million people in the world living with HIV and 2.6 million new infections every year [1]. The number of AIDS-related deaths worldwide has decreased from 2.1 million in 2004 to 1.8 million in 2009, J. A. Pellowski (*) : S. C. Kalichman Department of Psychology, University of Connecticut, 406 Babbidge Road, Unit 1020, Storrs, CT 06269, USA e-mail: [email protected] S. C. Kalichman e-mail: [email protected]
primarily due to success of and increased access to antiretroviral therapies [1]. However, people living with HIV (PLWH) in developing countries continue to face multiple challenges accessing care. In the United States, the HIV epidemic also continues to expand, with an estimated 1.1 million people infected with HIV and 50,000 new HIV infections each year [2]. It is estimated that 25 % of Americans infected with HIV are undiagnosed. In addition, as many as one in three of those diagnosed are not engaged in health care services [3]. Even individuals who are engaged in care do not necessarily benefit from treatment because of non-adherence to antiretroviral medications (ARVs). For more than a decade researchers have concentrated on developing and evaluating interventions aimed at testing, detecting, engaging, and treating PLWH with many interventions demonstrating positive outcomes. Meta-analyses show that behavioral interventions to improve medication adherence and reduce HIV transmission risk behaviors in those already infected have demonstrated efficacy [4, 5]. Because office and clinic based interventions are limited in reach and scalability, behavioral interventions are utilizing electronic and
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