The State of Adherence to HIV Care in Black Women.
Crystal Chapman Lambert, Michael J Mugavero, Yaseen S Najjar and 2 others
PMID 29764715WHAT IT FOUND
Depression, stigma, discrimination, poverty and clinic access were linked to poorer HIV care and medication adherence in Black women; reviewed interventions were inconsistent, and none were culturally tailored specifically for Black women.
Key findings
01Psychosocial factors, including depression, perceived HIV-related stigma, and perceived racial discrimination, were significantly linked to retention in care and ART adherence.
02No reviewed intervention was documented as culturally tailored specifically for Black women living with HIV.
03Intervention results were mixed: a group cognitive behavioral stress management plus health education trial reported increased self-reported ART adherence compared with individual education/information, while a peer-led multi-session symptom management trial found no significant difference compared with a symptom management manual.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only English-language, peer-reviewed studies published after January 2000, and detailed analysis was limited to U.S. studies with adults 18 years or older, so relevant work outside those limits may be missing. Many included studies were cross-sectional or qualitative, so they can show associations or describe experiences but cannot prove that changing a factor will improve adherence or retention. No reviewed intervention was documented as culturally tailored specifically for Black women living with HIV, so the paper does not offer a tested program for that population. Intervention evidence was limited and inconsistent; some studies were underpowered, both arms in some studies were group formats that could provide similar time and attention, and clinical trials without usual-care arms are limited in claiming efficacy. Retention in care was less frequently examined than ART adherence, so evidence for improving care retention is thinner. The authors state relevant literature may have been unintentionally omitted.
Declared interests
The article is listed as supported by NIH extramural research. No separate author conflict-of-interest declaration is provided in the supplied text.
The easy way to misread this
Do not conclude that any reviewed program has proven efficacy for Black women living with HIV. No culturally tailored interventions were documented, and the intervention results were inconsistent or limited by small size and study design.