Yale University

Initiation, adherence, and retention in a randomized controlled trial of directly administered antiretroviral therapy.

TitleInitiation, adherence, and retention in a randomized controlled trial of directly administered antiretroviral therapy.
Publication TypeJournal Article
Year of Publication2008
AuthorsMaru, Duncan Smith-Rohrberg, Douglas R. Bruce, Mary Walton, Jo Anne Mezger, Sandra A. Springer, David Shield, and Frederick L. Altice
JournalAIDS and behavior
Volume12
Issue2
Pagination284-93
Date Published2008 Mar
ISSN1090-7165
KeywordsAnti-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
AbstractDirectly 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.
DOI10.1007/s10461-007-9336-2
Alternate JournalAIDS Behav

External Links