Directly observed therapy (DOT) for individuals with HIV: successes and challenges.
Many HIV-infected individuals have not reaped the benefits of combination antiretroviral therapy due to inability either to adhere to medications or to access care. It is now recognized that innovative approaches are needed to increase access and adherence to highly active antiretroviral therapy (HAART), especially among these hard-to-reach populations. Due to the success of directly observed therapy (DOT) for the treatment of Mycobacterium tuberculosis (TB), our group and others have questioned whether DOT can be adapted to deliver HAART to hard-to-reach communities. In this review, we discuss the results of pilot programs that have utilized DOT in multiple different settings and use case studies to explore the diverse issues that can arise when implementing these programs. As we continue to gain more experience with observed therapy, we will be able to better identify the key components for a successful intervention.
Mitty
Jennifer Adelson
JA
Department of Medicine, The Miriam Hospital, and Brown University, Providence, Rhode Island, USA.
Macalino
Grace
G
Taylor
Lynn
L
Harwell
Joseph I
JI
Flanigan
Timothy P
TP
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods / Q000639:trends; D023801:Directly Observed Therapy / Q000379:methods* / Q000639:trends; D004334:Drug Administration Schedule; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D016312:Treatment Refusal
D019380:Anti-HIV Agents