The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.

<h4>Background</h4>The practice of involving people living with HIV in the development and provision of healthcare has gained increasing traction. Peer-support for people living with HIV is assistance and encouragement by an individual considered equal, in taking an active role in self-m...

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Autores principales:	Rigmor C Berg, Samantha Page, Anita Øgård-Repål
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b7eddb5ede504932906b54b0beae25c9
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spelling	oai:doaj.org-article:b7eddb5ede504932906b54b0beae25c92021-12-02T20:10:31ZThe effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.1932-620310.1371/journal.pone.0252623https://doaj.org/article/b7eddb5ede504932906b54b0beae25c92021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252623https://doaj.org/toc/1932-6203<h4>Background</h4>The practice of involving people living with HIV in the development and provision of healthcare has gained increasing traction. Peer-support for people living with HIV is assistance and encouragement by an individual considered equal, in taking an active role in self-management of their chronic health condition. The objective of this systematic review was to assess the effects of peer-support for people living with HIV.<h4>Methods</h4>We conducted a systematic review in accordance with international guidelines. Following systematic searches of eight databases until May 2020, two reviewers performed independent screening of studies according to preset inclusion criteria. We conducted risk of bias assessments and meta-analyses of the available evidence in randomised controlled trials (RCTs). The certainty of the evidence for each primary outcome was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation system.<h4>Results</h4>After screening 219 full texts we included 20 RCTs comprising 7605 participants at baseline from nine different countries. The studies generally had low risk of bias. Main outcomes with high certainty of evidence showed modest, but superior retention in care (Risk Ratio [RR] 1.07; Confidence Interval [CI] 95% 1.02-1.12 at 12 months follow-up), antiretroviral therapy (ART) adherence (RR 1.06; CI 95% 1.01-1.10 at 3 months follow-up), and viral suppression (Odds Ratio up to 6.24; CI 95% 1.28-30.5 at 6 months follow-up) for peer-support participants. The results showed that the current state of evidence for most other main outcomes (ART initiation, CD4 cell count, quality of life, mental health) was promising, but too uncertain for firm conclusions.<h4>Conclusions</h4>Overall, peer-support with routine medical care is superior to routine clinic follow-up in improving outcomes for people living with HIV. It is a feasible and effective approach for linking and retaining people living with HIV to HIV care, which can help shoulder existing services.<h4>Trial registration</h4>CRD42020173433.Rigmor C BergSamantha PageAnita Øgård-RepålPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252623 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Rigmor C Berg Samantha Page Anita Øgård-Repål The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.
description	<h4>Background</h4>The practice of involving people living with HIV in the development and provision of healthcare has gained increasing traction. Peer-support for people living with HIV is assistance and encouragement by an individual considered equal, in taking an active role in self-management of their chronic health condition. The objective of this systematic review was to assess the effects of peer-support for people living with HIV.<h4>Methods</h4>We conducted a systematic review in accordance with international guidelines. Following systematic searches of eight databases until May 2020, two reviewers performed independent screening of studies according to preset inclusion criteria. We conducted risk of bias assessments and meta-analyses of the available evidence in randomised controlled trials (RCTs). The certainty of the evidence for each primary outcome was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation system.<h4>Results</h4>After screening 219 full texts we included 20 RCTs comprising 7605 participants at baseline from nine different countries. The studies generally had low risk of bias. Main outcomes with high certainty of evidence showed modest, but superior retention in care (Risk Ratio [RR] 1.07; Confidence Interval [CI] 95% 1.02-1.12 at 12 months follow-up), antiretroviral therapy (ART) adherence (RR 1.06; CI 95% 1.01-1.10 at 3 months follow-up), and viral suppression (Odds Ratio up to 6.24; CI 95% 1.28-30.5 at 6 months follow-up) for peer-support participants. The results showed that the current state of evidence for most other main outcomes (ART initiation, CD4 cell count, quality of life, mental health) was promising, but too uncertain for firm conclusions.<h4>Conclusions</h4>Overall, peer-support with routine medical care is superior to routine clinic follow-up in improving outcomes for people living with HIV. It is a feasible and effective approach for linking and retaining people living with HIV to HIV care, which can help shoulder existing services.<h4>Trial registration</h4>CRD42020173433.
format	article
author	Rigmor C Berg Samantha Page Anita Øgård-Repål
author_facet	Rigmor C Berg Samantha Page Anita Øgård-Repål
author_sort	Rigmor C Berg
title	The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.
title_short	The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.
title_full	The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.
title_fullStr	The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.
title_full_unstemmed	The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.
title_sort	effectiveness of peer-support for people living with hiv: a systematic review and meta-analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b7eddb5ede504932906b54b0beae25c9
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The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis.

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