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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Randomized control trial of peer-delivered, modified directly observed therapy for HAART in Mozambique
Journal of Acquired Immune Deficiency Syndromes, Volume 46, No. 2, Year 2007
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Description
OBJECTIVE: To assess the efficacy of a peer-delivered intervention to promote short-term (6-month) and long-term (12-month) adherence to HAART in a Mozambican clinic population. DESIGN: A 2-arm randomized controlled trial was conducted between October 2004 and June 2006. PARTICIPANTS: Of 350 men and women (≥18 years) initiating HAART, 53.7% were female, and 97% were on 1 fixed-dose combination pill twice a day. INTERVENTION: Participants were randomly assigned to receive 6 weeks (Monday through Friday; 30 daily visits) of peer-delivered, modified directly observed therapy (mDOT) or standard care. Peers provided education about treatment and adherence and sought to identify and mitigate adherence barriers. OUTCOME: Participants' self-reported medication adherence was assessed 6 months and 12 months after starting HAART. Adherence was defined as the proportion of prescribed doses taken over the previous 7 days. Statistical analyses were performed using intention-to-treat (missing = failure). RESULTS: Intervention participants, compared to those in standard care, showed significantly higher mean medication adherence at 6 months (92.7% vs. 84.9%, difference 7.8, 95% confidence interval [CI]: 0.0.02, 13.0) and 12 months (94.4% vs. 87.7%, difference 6.8, 95% CI: 0.9, 12.9). There were no between-arm differences in chart-abstracted CD4 counts. CONCLUSIONS: A peer-delivered mDOT program may be an effective strategy to promote long-term adherence among persons initiating HAART in resource-poor settings. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Pearson, Cynthia R.
United States, Seattle
University of Washington
Micek, Mark A.
United States, Seattle
Health Alliance International
Mozambique, Maputo
Ministry of Health Mozambique
Simoni, Jane M.
United States, Seattle
University of Washington
Hoff, P.
Unknown Affiliation
Matediana, Eduardo
United States, Seattle
University of Washington
Martin, Diane P.
Mozambique, Maputo
Ministry of Health Mozambique
Gloyd, Stephen S.
United States, Seattle
Health Alliance International
United States, Seattle
University of Washington School of Public Health and Community Medicine
Statistics
Citations: 138
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1097/QAI.0b013e318153f7ba
ISSN:
15254135
Research Areas
Health System And Policy
Study Design
Randomised Control Trial
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Mozambique
Participants Gender
Male
Female