Commentary on meta-analysis of randomized controlled trials for HIV treatment adherence interventions. Research directions and implications for practice.

This meta-analysis of randomized controlled trials (RCTs) of interventions for adherence to antiretroviral therapy for HIV indicates that participants who received an adherence intervention were 1.5 times as likely to report 95% adherence and 1.25 times as likely to achieve an undetectable viral load than participants in comparison conditions. The magnitude of the aggregated intervention effect is an encouraging message for HIV treatment providers, but more work is needed. For the next generation of international adherence research, there are multiple challenges that require the collaboration of providers, patients, government funders, donor agencies, and policy-makers. This commentary examines the strengths and limitations of the evidence base, identifies critical research directions, and calls for the development of a formal process to guide the rapid implementation of efficacious adherence interventions into community and clinical practice.