2013
DOI: 10.1371/journal.pone.0068286
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Directly Administered Antiretroviral Therapy for HIV-Infected Individuals in Opioid Treatment Programs: Results from a Randomized Clinical Trial

Abstract: BackgroundData regarding the efficacy of directly administered antiretroviral therapy (DAART) are mixed. Opioid treatment programs (OTPs) provide a convenient framework for DAART. In a randomized controlled trial, we compared DAART and self-administered therapy (SAT) among HIV-infected subjects attending five OTPs in Baltimore, MD.MethodsHIV-infected individuals attending OTPs were eligible if they were not taking antiretroviral therapy (ART) or were virologically failing ART at last clinical assessment. In su… Show more

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Cited by 16 publications
(10 citation statements)
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“…Lucas et al . evaluated the efficacy of a DAART intervention embedded within an OAT program [49]. In this study, rates of ART adherence and viral suppression at 12 months were overall low, with no differences between participants in the DAART and self-administered arm, contradicting previous RCTs in this area.…”
Section: Interventions To Improve Adherence Among Pwudmentioning
confidence: 80%
“…Lucas et al . evaluated the efficacy of a DAART intervention embedded within an OAT program [49]. In this study, rates of ART adherence and viral suppression at 12 months were overall low, with no differences between participants in the DAART and self-administered arm, contradicting previous RCTs in this area.…”
Section: Interventions To Improve Adherence Among Pwudmentioning
confidence: 80%
“…Comprehensive and integrated healthcare, incorporating addiction treatment in primary care [34], is clearly critical for the successful treatment of HIV-positive individuals with opioid dependence. In this regard, integrated ‘directly observed therapy’ programmes, combining OST and HAART medication pickups, have shown mixed results, but continue to be assessed [35,36]. …”
Section: Discussionmentioning
confidence: 99%
“…57 The best evidence to improve ART adherence is using DAART, 5861 yet one recent study of stably methadone-maintained patients did not confirm this benefit. 62 While DAART may involve increased human resources and be logistically challenging, a cost-effectiveness study integrating DAART into MMT support its use, especially in LMIC settings. 63 Considerable evidence for OST with buprenorphrine or methadone for opioid dependent patients exists to improve retention in care, ART uptake, ART adherence, and viral suppresion.…”
Section: Challenges In Treatment Access and Care Retentionmentioning
confidence: 99%