Meta-analysis demonstrates that Wisepill improves viral load suppression in adolescents and young adults with HIV, suggesting its important role in treatment strategies.
Adolescents and young adults (AYA) with HIV in sub-Saharan Africa face challenges in achieving viral load suppression, with suboptimal adherence to antiretroviral therapy a primary barrier. Digital adherence technologies, including the Wisepill device, have been deployed in Harare, Zimbabwe, to support medication-taking, but their aggregated effect on virological outcomes in this specific demographic and locale is unclear. This meta-analysis aimed to synthesise existing evidence to determine the impact of the Wisepill digital adherence technology on viral load suppression among AYA living with HIV in Harare, Zimbabwe. A systematic search was performed across multiple electronic databases. Included studies were randomised controlled trials, cohort studies, and pre-post intervention studies reporting on Wisepill use and viral load outcomes in AYA (aged 10–24 years) with HIV in Harare. Data extraction was conducted independently by two reviewers. A random-effects meta-analysis was used to pool effect estimates, with heterogeneity assessed via the I² statistic. The pooled analysis demonstrated a statistically significant positive association between Wisepill use and viral load suppression. The summary odds ratio for achieving suppression was 2.45 (95% CI 1.78 to 3.38). This indicates that AYA using the device were more than twice as likely to be virally suppressed compared to those receiving standard care. Wisepill digital adherence technology is associated with a substantially increased likelihood of viral load suppression among adolescents and young adults with HIV in Harare. This supports its utility as a component of a comprehensive adherence support strategy for this population. Programme planners should consider integrating Wisepill technology into differentiated service delivery models for AYA. Further implementation research is required to understand long-term sustainability, cost-effectiveness, and the optimal complementary support structures needed. HIV, adolescents, young adults, adherence, viral load suppression, digital health, meta-analysis, Zimbabwe. This meta-analysis provides a consolidated quantitative estimate of the effect of a specific digital adherence technology on a critical treatment outcome for a vulnerable population, informing public health practice and resource allocation in similar settings.
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Moyo et al. (2010) studied this question.
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