TY - JOUR AB - Objective: Adolescent and young adult (AYA) populations (12–24 years) representover 40% of new HIV infections globally. Adolescence is sometimes characterized byhigh-risk sexual behaviour and a lack of engagement with healthcare services that canaffect adherence to antiretroviral therapy (ART). Despite adherence to ART beingcritical in controlling viral replication, maintaining health and reducing onward viraltransmission, there are limited data on ART adherence amongst AYA globally. Weundertook a systematic review and meta-analysis of published studies reportingadherence to ART for AYA living with HIV.Design and methods: Searches included Embase, Medline and PsychINFO databasesup to 14 August 2013. Eligible studies defined adequate adherence as at least 85% onself-report or undetectable blood plasma virus levels. A random effects meta-analysiswas performed and heterogeneity examined using meta-regression.Results: We identified 50 eligible articles reporting data from 53 countries and 10 725patients. Using a pooled analysis of all eligible studies, 62.3% [95% confidence interval(CI) 57.1–67.6; I2 : 97.2%] of the AYA population were adherent to therapy. The lowestaverage ART adherence was in North America [53% (95% CI 46–59; I2 : 91%)], Europe[62% (95% CI 51–73; I2 : 97%)] and South America [63% (95% CI 47–77; I2 : 85%]and, with higher levels in Africa [84% (95% CI 79–89; I2 : 93%)] and Asia [84% (95% CI77–91; I2 : 0%].Conclusion: Review of published literature from Africa and Asia indicate more than70% of HIV-positive AYA populations receiving ART are adherent to therapy and lowerrates of adherence were shown in Europe and North America at 50–60%. The globaldiscrepancy is probably multifactorial reflecting differences between focused andgeneralised epidemics, access to healthcare and funding. AU - Kim,S-H AU - Gerver,SM AU - Fidler,S AU - Ward,H DO - 10.1097/QAD.0000000000000316 EP - 1956 PY - 2014/// SN - 0269-9370 SP - 1945 TI - Adherence to antiretroviral therapy in adolescents living with HIV: systematic review and meta-analysis T2 - AIDS UR - http://dx.doi.org/10.1097/QAD.0000000000000316 UR - http://hdl.handle.net/10044/1/27501 VL - 28 ER -