| Title | Initiation, adherence, and retention in a randomized controlled trial of directly administered antiretroviral therapy. |
| Publication Type | Journal Article |
| Year of Publication | 2008 |
| Authors | Maru, Duncan Smith-Rohrberg, Douglas R. Bruce, Mary Walton, Jo Anne Mezger, Sandra A. Springer, David Shield, and Frederick L. Altice |
| Journal | AIDS and behavior |
| Volume | 12 |
| Issue | 2 |
| Pagination | 284-93 |
| Date Published | 2008 Mar |
| ISSN | 1090-7165 |
| 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 |
| 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. |
| DOI | 10.1007/s10461-007-9336-2 |
| Alternate Journal | AIDS Behav |
