Effect of Directly Observed Antiretroviral Therapy Compared to Self-Administered Antiretroviral Therapy on Adherence and Virological Outcomes among HIV-Infected Prisoners: A Randomized Controlled Pilot Study
AIDS and Behavior, ISSN: 1573-3254, Vol: 19, Issue: 1, Page: 128-136
2015
- 18Citations
- 75Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations18
- Citation Indexes11
- 11
- CrossRef7
- Policy Citations7
- Policy Citation7
- Captures75
- Readers75
- 75
Article Description
The effect of directly observed therapy (DOT) versus self-administered therapy (SAT) on antiretroviral (ART) adherence and virological outcomes in prison has never been assessed in a randomized, controlled trial. Prisoners were randomized to receive ART by DOT or SAT. The primary outcome was medication adherence [percent of ART doses measured by the medication event monitoring system (MEMS) and pill counts] at the end of 24 weeks. The changes in the plasma viral loads from baseline and proportion of participants virological suppressed (<400 copies/mL) at the end of 24 weeks were assessed. Sixty-six percent (90/136) of eligible prisoners declined participation. Participants in the DOT arm (n = 20) had higher viral loads than participants in the SAT (n = 23) arm (p = 0.23). Participants, with complete data at 24 weeks, were analyzed as randomized. There were no significant differences in median ART adherence between the DOT (n = 16, 99% MEMS [IQR 93.9, 100], 97.1 % pill count [IQR 95.1, 99.3]) and SAT (n = 21, 98.3 % MEMS [IQR 96.0, 100], 98.5 % pill count [95.8, 100]) arms (p = 0.82 MEMS, p = 0.40 Pill Count) at 24 weeks. Participants in the DOT arm had a greater reduction in viral load of approximately −1 log 10 copies/mL [IQR −1.75, −0.05] compared to −0.05 [IQR −0.45, 0.51] in the SAT arm (p value = 0.02) at 24 weeks. The proportion of participants achieving virological suppression in the DOT vs SAT arms was not statistically different at 24 weeks (53 % vs 32 %, p = 0.21). These findings suggest that DOT ART programs in prison settings may not offer any additional benefit on adherence than SAT programs.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84939878356&origin=inward; http://dx.doi.org/10.1007/s10461-014-0850-8; http://www.ncbi.nlm.nih.gov/pubmed/25055766; http://link.springer.com/10.1007/s10461-014-0850-8; https://dx.doi.org/10.1007/s10461-014-0850-8; https://link.springer.com/article/10.1007/s10461-014-0850-8; http://link.springer.com/article/10.1007/s10461-014-0850-8?no-access=true; https://link.springer.com/content/pdf/10.1007%2Fs10461-014-0850-8.pdf; http://link.springer.com/content/pdf/10.1007/s10461-014-0850-8.pdf; http://link.springer.com/article/10.1007%2Fs10461-014-0850-8; http://link.springer.com/content/pdf/10.1007/s10461-014-0850-8
Springer Science and Business Media LLC
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