Evidence map›Paper›PMID 25558105›Full record

SynthesisBulletin of the World Health Organization2015

Association between antiretroviral therapy adherence and employment status: systematic review and meta-analysis.

Jean B Nachega, Olalekan A Uthman, Karl Peltzer, Lindsey A Richardson, Edward J Mills, Kofi Amekudzi, Alice Ouédraogo

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Bulletin of the World Health Organization, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jean B NachegaDepartment of Epidemiology, University of Pittsburgh Graduate School of Public Health, 503 Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261, United States of America (USA).
Olalekan A UthmanWarwick Centre for Applied Health Research and Delivery, University of Warwick, Coventry, England .
Karl PeltzerDepartment of Psychology, University of Limpopo, Turfloop, South Africa .
Lindsey A RichardsonDepartment of Sociology, University of British Columbia, Vancouver, Canada .
Edward J MillsStanford Prevention Research Center, Stanford University, Stanford, USA .
Kofi AmekudziHIV/AIDS and the World of Work Branch (ILOAIDS), International Labour Organization, Geneva, Switzerland .
Alice OuédraogoHIV/AIDS and the World of Work Branch (ILOAIDS), International Labour Organization, Geneva, Switzerland .

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the association between the employment status of human immunodeficiency virus (HIV)-infected individuals and adherence to antiretroviral therapy (ART).

methodsWe searched the Medline, Embase and Cochrane Central Register of Controlled Trials databases for studies reporting ART adherence and employment status published between January 1980 and September 2014. Information from a wide range of other sources, including the grey literature, was also analysed. Two independent reviewers extracted data on treatment adherence and study characteristics. Study data on the association between being employed and adhering to ART were pooled using a random-effects model. Between-study heterogeneity and sources of bias were evaluated.

findingsThe meta-analysis included 28 studies published between 1996 and 2014 that together involved 8743 HIV-infected individuals from 14 countries. The overall pooled odds ratio (OR) for the association between being employed and adhering to ART was 1.27 (95% confidence interval, CI: 1.04-1.55). The association was significant for studies from low-income countries (OR: 1.85, 95% CI: 1.58-2.18) and high-income countries (OR: 1.33, 95% CI: 1.02-1.74) but not middle-income countries (OR: 0.94, 95% CI: 0.62-1.42). In addition, studies published after 2011 and larger studies showed less association between employment and adherence than earlier and small studies, respectively.

conclusionEmployed HIV-infected individuals, particularly those in low- and high-income countries, were more likely to adhere to ART than unemployed individuals. Further research is needed on the mechanisms by which employment and ART adherence affect each other and on whether employment-creation interventions can positively influence ART adherence, HIV disease progression and quality of life.

Indexed as

Drug MonitoringAnti-HIV AgentsDeveloped CountriesDeveloping CountriesEmploymentHIV InfectionsHumansAnti-HIV Agents

Identifiers

PMID25558105
PMCPMC4271680

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.