Community-based DOT-HAART accompaniment in an urban resource-poor setting.
From December 2005 to April 2007, we enrolled 60 adults starting antiretroviral therapy (ART) in a health district of Lima, Peru to receive community-based accompaniment with supervised antiretroviral (CASA). Paid community health workers performed twice-daily home visits to directly observe ART and offered additional medical, social and economic support to CASA participants. We matched 60 controls from a neighboring district by age, CD4 and primary referral criteria (TB status, female, neither). Using validated instruments at baseline and 12 months (time of DOT-HAART completion) we measured depression, social support, quality of life, HIV-related stigma and self-efficacy. We compared 12 month clinical and psychosocial outcomes among CASA versus control groups. CASA participants experienced better clinical and psychosocial outcomes at 12 months, including proportion with virologic suppression, increase in social support and reduction in HIV-associated stigma.
Muñoz
Maribel
M
Socios En Salud Sucursal Perú, Lima, Peru.
Finnegan
Karen
K
Zeladita
Jhon
J
Caldas
Adolfo
A
Sanchez
Eduardo
E
Callacna
Miriam
M
Rojas
Christian
C
Arevalo
Jorge
J
Sebastian
Jose Luis
JL
Bonilla
Cesar
C
Bayona
Jaime
J
Shin
Sonya
S
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D016022:Case-Control Studies; D003153:Community Health Services; D023801:Directly Observed Therapy; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D008297:Male; D010568:Peru; D011203:Poverty; D011584:Psychology; D012944:Social Support; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy; D014505:Urban Population; D055815:Young Adult