The feasibility of a community-based directly administered antiretroviral therapy program.
Improved treatment-adherence support programs are needed to help human immunodeficiency virus (HIV)-infected persons comply with complex highly active antiretroviral treatment (HAART) regimens. In an experimental directly administered antiretroviral therapy (DAART) program, treatment-naive and treatment-experienced persons who experienced failure of no more than 1 prior regimen were recruited from 3 public HIV/AIDS clinics in Los Angeles County. For 6 months, trained community workers observed ingestion of 1 of 2 daily HAART doses, 5 days per week, and questioned the patient about the second dose, which enabled intense adherence monitoring and real-time intervention. From November 2001 through November 2003, there were 67 DAART patients enrolled (69% Latino, 21% African American, and 9% white; 63% with annual income of <10,000 dollars). Preliminary findings show that a DAART program based in 3 public HIV/AIDS clinics was feasible in a low-income urban population. Effective communication between the DAART staff, the medical providers, and the pharmacy is essential for the successful implementation of this program.
Wohl
Amy Rock
AR
HIV Epidemiology Program, Los Angeles County Department of Health Services, Los Angeles, CA 90005, USA. awohl@dhs.co.la.ca.us
Garland
Wendy H
WH
Squires
Kathleen
K
Witt
Mallory
M
Larsen
Robert
R
Kovacs
Andrea
A
Hader
Shannon
S
Weidle
Paul J
PJ
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D023801:Directly Observed Therapy; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006282:Health Personnel; D006287:Health Planning Guidelines; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011203:Poverty
D019380:Anti-HIV Agents