Directly observed antiretroviral therapy improves adherence and viral load in drug users attending methadone maintenance clinics: A randomized controlled trial
| Autor: | Xuan Li, Alain H. Litwin, Moonseong Heo, Karina M. Berg, Julia H. Arnsten |
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| Rok vydání: | 2011 |
| Předmět: |
Male
medicine.medical_specialty Methadone maintenance HIV Infections Toxicology Article Medication Adherence law.invention Pharmacotherapy Randomized controlled trial Acquired immunodeficiency syndrome (AIDS) law Antiretroviral Therapy Highly Active Internal medicine Opiate Substitution Treatment Humans Medicine Pharmacology (medical) Directly Observed Therapy Pharmacology business.industry Middle Aged Viral Load Opioid-Related Disorders medicine.disease Clinical trial Psychiatry and Mental health Immunology Female Substance Abuse Treatment Centers business Viral load Methadone medicine.drug |
| Zdroj: | Drug and Alcohol Dependence. 113:192-199 |
| ISSN: | 0376-8716 |
| Popis: | To determine if directly observed antiretroviral therapy (DOT) is more efficacious than self-administered therapy for improving adherence and reducing HIV viral load (VL) among methadone-maintained opioid users.Two-group randomized trial.Twelve methadone maintenance clinics with on-site HIV care in the Bronx, New York.HIV-infected adults prescribed combination antiretroviral therapy.Between group differences at four assessment points from baseline to week 24 in: (1) antiretroviral adherence measured by pill count, (2) VL, and (3) proportion with undetectable VL (75 copies/ml).Between June 2004 and August 2007, we enrolled 77 participants. Adherence in the DOT group was higher than in the control group at all post-baseline assessment points; by week 24 mean DOT adherence was 86% compared to 56% in the control group (p0.0001). Group differences in mean adherence remained significant after stratifying by baseline VL (detectable versus undetectable). In addition, during the 24-week intervention, the proportion of DOT participants with undetectable VL increased from 51% to 71%.Among HIV-infected opioid users, antiretroviral DOT administered in methadone clinics was efficacious for improving adherence and decreasing VL, and these improvements were maintained over a 24-week period. DOT should be more widely available to methadone patients. |
| Databáze: | OpenAIRE |
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