@article {1331,
	title = {Developing a directly administered antiretroviral therapy intervention for HIV-infected drug users: implications for program replication.},
	journal = {Clinical infectious diseases : an official publication of the Infectious Diseases Society of America},
	volume = {38 Suppl 5},
	year = {2004},
	month = {2004 Jun 1},
	pages = {S376-87},
	abstract = {Directly administered antiretroviral therapy (DAART) is one approach to improving adherence to among human immunodeficiency virus (HIV)-infected drug users. We evaluated the essential features of a community-based DAART intervention in a randomized, controlled trial of DAART versus self-administered therapy. Of the initial 72 subjects, 78\% were racial minorities, and 32\% were women. Social and medical comorbidities among subjects included homelessness (35\% of subjects), lack of interpersonal support (86\%), major depression (57\%), and alcoholism (36\%). At baseline, the median CD4+ cell count was 403 cells/mL and the median HIV-1 RNA load was 146,333 copies/mL (log10 5.31 copies/mL). During the prior 6 months, 33\% of subjects had missed a medical appointment, and 47\% had visited an emergency department. Although most subjects (67\%) preferred to take their own medications, 76\% would accept DAART if it were made compulsory. A methadone clinic was the DAART venue acceptable to the fewest subjects (36\%), and a mobile syringe-exchange program was acceptable to the most subjects (83\%). Adherence was higher for supervised than for unsupervised medication administration (P<.0001), a finding that supports use of daily supervision of once-daily regimens. Moreover, DAART should incorporate enhanced elements such as convenience, flexibility, confidentiality, cues and reminders, responsive pharmacy and medical services, and specialized training for staff.},
	keywords = {Adult, Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Directly Observed Therapy, Female, HIV Infections, HIV-1, Humans, Male, Patient Compliance, RNA, Viral, Self Administration, Substance-Related Disorders, Treatment Outcome, Viral Load},
	issn = {1537-6591},
	doi = {10.1007/s11904-011-0095-3},
	author = {Altice, Frederick L and Mezger, Jo Anne and Hodges, John and Bruce, Robert D and Marinovich, Adrian and Walton, Mary and Springer, Sandra A and Friedland, Gerald H}
}
