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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Doubts about DOT: Antiretroviral therapy for resource-poor countries
AIDS, Volume 17, No. 9, Year 2003
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Description
Introduction: Directly observed therapy programs developed for tuberculosis (TB) have been suggested as a model for the provision of HIV medications in resource-poor countries in order to ensure adherence and prevent drug resistance. Methods: Opinions were formed based on a review of scientific literature regarding the effectiveness of witnessed dosing in directly observed TB therapy programs, adherence to HIV antiretroviral therapy in resource-rich and resource-poor settings, relationship between adherence and HIV antiretroviral drug resistance, HIV viral load and risk of HIV transmission, and stigmatization concerns related to HIV and TB in resource-poor settings. Results/conclusions: We suggest that the enthusiasm for HIV directly observed therapy programs is premature based on: equivocal evidence that witnessed dosing is superior to self administered therapy; mistaken assumptions that resource-poor countries are a 'special case' with respect to adherence; possible paradoxical impact of good adherence on HIV drug resistance; unproven efficacy of antiretroviral therapy in preventing HIV transmission; and potential stigmatization of daily antiretroviral dosing. © 2003 Lippincott Williams & Wilkins.
Authors & Co-Authors
Liechty, Cheryl A.
Uganda, Kampala
San Francisco General Hospital
Bangsberg, David R.
Uganda, Kampala
San Francisco General Hospital
United States, San Francisco
San Francisco General Hospital and Trauma Center
Statistics
Citations: 73
Authors: 2
Affiliations: 2
Identifiers
Doi:
10.1097/00002030-200306130-00013
Research Areas
Infectious Diseases
Maternal And Child Health