@article {1308, title = {Initiation, adherence, and retention in a randomized controlled trial of directly administered antiretroviral therapy.}, journal = {AIDS and behavior}, volume = {12}, year = {2008}, month = {2008 Mar}, pages = {284-93}, abstract = {Directly administered antiretroviral therapy (DAART) can improve health outcomes among HIV-infected drug users. An understanding of the utilization of DAART-initiation, adherence, and retention-is critical to successful program design. Here, we use the Behavioral Model to assess the enabling, predisposing, and need factors impacting adherence in our randomized, controlled trial of DAART versus self-administered therapy (SAT) among 141 HIV-infected drug users. Of 88 participants randomized to DAART, 74 (84\%) initiated treatment, and 51 (69\%) of those who initiated were retained in the program throughout the entire six-month period. Mean adherence to directly observed visits was 73\%, and the mean overall composite adherence score was 77\%. These results were seen despite the finding that 75\% of participants indicated that they would prefer to take their own medications. Major causes of DAART discontinuation included hospitalization, incarceration, and entry into drug-treatment programs. The presence of depression and the lack of willingness to travel greater than four blocks to receive DAART predicted time-to-discontinuation.}, keywords = {Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Directly Observed Therapy, Guideline Adherence, Health Services, HIV Infections, HIV-1, Humans, Patient Compliance, Retention (Psychology), Self Administration, Substance-Related Disorders, Treatment Outcome}, issn = {1090-7165}, doi = {10.1007/s10461-007-9336-2}, author = {Maru, Duncan Smith-Rohrberg and Bruce, R Douglas and Walton, Mary and Mezger, Jo Anne and Springer, Sandra A and Shield, David and Altice, Frederick L} }