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DOT for HAART
Abstract II |
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Edmonton DOT for HAART II:
Edmonton directly observed therapy (DOT) for highly active antiretroviral therapy (HAART) project I: treating the untreatable in the inner city Wendi Monahan*, Roger Millard*, Peter Akai
Background:
Human immunodeficiency virus (HIV) positive patients with a history of homelessness or a chaotic lifestyle are typically considered poor candidates for HAART because of their potential non-compliance. Such patients may benefit from daily DOT in an appropriate setting to increase adherence to HAART.
Objective: To demonstrate efficacy of a DOT for HAART program in promoting adherence to HAART and decreased HIV-related morbidity for traditionally non-compliant HIV-positive patients in inner-city Edmonton.
Method:
Appropriate and effective incentives and psychosocial supports are provided to encourage a homeless or high risk inner city HIV positive population to adhere to daily DOT for HAART. Patients are referred by HIV specialist physicians who also establish and maintain appropriate once or twice daily HAART regimens for each patient. Indicators of efficacy include adequate patient representation, high patient adherence rates and HIV awareness, decreased HIV viral loads, increased CD4 counts, improved general health indicators and collaborative interactions with the HIV treatment community.
Conclusion: DOT for HAART can be effectively delivered to a traditionally non-compliant and untreatable HIV positive inner-city population. This improves HIV disease parameters and overall health and may contribute to decreased HIV drug resistance and transmission. |