title: The feasibility of a community-based directly administered antiretroviral therapy program.
abstract: 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.
authors.affiliation: HIV Epidemiology Program, Los Angeles County Department of Health Services, Los Angeles, CA 90005, USA. awohl@dhs.co.la.ca.us
authors.forename: Amy Rock
authors.initials: AR
authors.lastname: Wohl
authors.forename: Wendy H
authors.initials: WH
authors.lastname: Garland
authors.forename: Kathleen
authors.initials: K
authors.lastname: Squires
authors.forename: Mallory
authors.initials: M
authors.lastname: Witt
authors.forename: Robert
authors.initials: R
authors.lastname: Larsen
authors.forename: Andrea
authors.initials: A
authors.lastname: Kovacs
authors.forename: Shannon
authors.initials: S
authors.lastname: Hader
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Weidle
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents