Family support in reducing morbidity and mortality in HIV-infected persons

Mohanan P, Kamath A

Published Online:

July 8, 2009

There is a lack of evidence from randomized controlled trials to show the impact of family support as an intervention in treating people living with HIV/AIDS (PLHA) in developing countries. Family support affects PLHA on many levels and includes financial assistance, support in the disclosure process, routine daily activities, and medical assistance or psychological support. Studies from developed countries as well as relevant non-intervention studies suggest that family support makes multiple levels of positive impact on people living with HIV/AIDS. Perceived family support for HIV-positive women predicts an increase in mental health across several areas and includes reducing anxiety, stress, depressive symptoms, and loneliness over a period of time. Our main conclusion from this review, however, is that more rigorous studies are required in developing countries before substantive conclusions can be drawn about the effects of family support in reducing morbidity and mortality in HIV-infected persons.

Abstract (click to read)

Background:

Care and support play a critical role in assisting people who are HIV-positive to understand the need for prevention and to enable them to protect others. As the HIV/AIDS pandemic progresses and HIV-seropositive individuals contend with devastating illness, it seemed timely to inquire if they receive support from family members. It also was important to develop a normative idea of how much family support exists and from whom it emanates.

Objectives:

To assess the effect of family support on morbidity, mortality, quality of life, and economics in families with at least one HIV-infected member, in developing countries.

Search strategy:

The following databases were searched:

The Cochrane Central Register for Controlled Trials (CENTRAL), the Cochrane Database of Systematic Reviews, MEDLINE, AIDSLINE, CINAHL, Dissertation Abstracts International (DAI), EMBASE, BIOSIS, SCISEARCH, the Cochrane HIV/AIDS group specialized register, INDMED, Proquest, and various South Asian abstracting databases, will be included in the database list. The publication sites of the World Health Organization, the US Centers for Disease Control and Prevention, and other international research and non-governmental organizations. An extensive search strategy string was developed in consultation with the trial search coordinator of the HIV/AIDS Review Group. Numerous relevant keywords were included in the string to get an exhaustive electronic literature search. The search was not restricted by language. Articles from other languages were translated into English with the help of experts. A hand search was carried out in many journals and abstracts of the conference proceedings of national and international conferences related to AIDS (e.g. the International Conference on HIV/AIDS and STI in Africa [ICASA]). Efforts also were made to contact experts to identify unpublished research and trials still underway.

Selection criteria:

Intervention studies. Randomized control trials (RCTs) and quasi-RCTs involving HIV-infected individuals with family support in developing countries.

Data collection and analysis:

We independently screened the results of the search to select potentially relevant studies and to retrieve the full articles. We independently applied the inclusion criteria to the potentially relevant studies. No studies were identified that fulfilled the selection criteria.

Main results:

We were unable to find any trials of family support in reducing the morbidity and mortality in HIV-infected persons in developing countries.

Authors' conclusions:

There is insufficient evidence to bring out the effect of family support in reducing the morbidity and mortality of HIV-infected persons in developing countries. This review has highlighted the dearth of high-quality quantitative research about family support. There is a clear need for rigorous studies of the clinical effects of family support on people with HIV in developing countries.

This record should be cited as:

Mohanan P, Kamath A. Family support for reducing morbidity and mortality in people with HIV/AIDS. Cochrane Database of Systematic Reviews 2009, Issue 3. Art. No.: CD006046. DOI: 10.1002/14651858.CD006046.pub2

Assessed as up to date:

December 31, 2006

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Primary Review Group:

HIV/AIDS Group

Health topics:

Infectious disease > HIV/AIDS > Health services & care

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Family support in reducing morbidity and mortality in HIV-infected persons

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