Evidence map›Paper›PMID 40821109›Full record

ArticleNature. Mental health2025

Cognitive behavioral therapy for antiretroviral therapy adherence and treatment outcomes among people living with HIV: a systematic review and meta-analysis.

David R A Coelho, Belinda J Njiro, Mashavu H Yussuf, Wigilya P Mikomangwa, Willians Fernando Vieira, Stefania Papatheodorou, Paul A Bain, Bruno F Sunguya, Mary Mwanyika Sando, Carolina Coutinho and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nature. Mental health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Trial
  2. Article
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

18 authors.

David R A CoelhoHarvard T. H. Chan School of Public Health, Boston, MA, USA.ORCID 0000-0003-4217-2399
Belinda J NjiroSchool of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Mashavu H YussufAfrica Academy for Public Health (AAPH), Dar es Salaam, Tanzania.
Wigilya P MikomangwaSchool of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Willians Fernando VieiraDepartment of Anatomy, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
Stefania PapatheodorouDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Paul A BainCountway Library, Harvard Medical School, Boston, MA, USA.
Bruno F SunguyaSchool of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Mary Mwanyika SandoAfrica Academy for Public Health (AAPH), Dar es Salaam, Tanzania.
Carolina CoutinhoEvandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Valdilea G VelosoEvandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Beatriz GrinsztejnEvandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Muhammad BakariSchool of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Christopher R SudfeldDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Wafaie W FawziDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Kenneth H MayerDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Sari L ReisnerDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Alex S KeuroghlianThe Fenway Institute, Fenway Health, Boston, MA, USA.

Funding

Training Tanzanian Researchers for HIV/AIDS Implementation ScienceD43TW009775 · FIC · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Wafaie W Fawzi, Christopher Sudfeld · 2015 to 2026
$3.0M
FIC NIH HHS D43 TW009775
6 · The paper itself

Abstract

Cognitive behavioral therapy has emerged as a promising intervention to enhance antiretroviral therapy adherence among people living with HIV. Here we conducted a systematic review and meta-analysis to evaluate the efficacy of cognitive behavioral therapy to improve antiretroviral therapy adherence, HIV viral load, viral suppression and CD4 counts. A total of 20 randomized controlled trials involving 1,739 people living with HIV were included, with most of the studies categorized as having low risk of bias. We show that cognitive behavioral therapy was associated with improved antiretroviral therapy adherence, with more pronounced effects for people living with HIV with psychiatric comorbidities and in studies conducted in low- and middle-income countries. No statistically significant findings were observed for HIV viral load, viral suppression or CD4 counts. These findings support the efficacy of cognitive behavioral therapy in enhancing antiretroviral therapy adherence, particularly for those with psychiatric comorbidities and in low- and middle-income countries. However, the impact of cognitive behavioral therapy on HIV viral load, viral suppression and CD4 counts remains inconclusive.

Identifiers

PMID40821109
PMCPMC12352344

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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.