International Journal of STD & AIDS > Volume 18, Number 11 > Pp. 760-763

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Original research articles

Direct observation therapy-highly active antiretroviral therapy in a resource-limited setting: the use of community treatment support can be effective

J A Idoko, O Agbaji, P Agaba, C Akolo, B Inuwa, Zuweira Hassan, L Akintunde, B Badung, M Muazu, M Danang, G Imade, J Louis Sankale and Phyllis Kanki

AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; AIDS Prevention Imitative in Nigeria (APIN) Centre, Jos University Teaching Hospital (JUTH), Jos, Nigeria; Harvard School of Public Health, Boston, MA, USA; Harvard School of Public Health, Boston, MA, USA

This study examines the use of various direct observation therapy-HAART treatment support modalities in Jos, Nigeria. A 12-month observational study enrolling 175 antiretroviral naïve patients into four arms of direct observation therapy-HAART (highly active antiretroviral therapy); daily observed therapy (DOT), twice weekly observed therapy (TWOT), weekly observed therapy (WOT) and self-administered therapy (SAT), examined community treatment support using family and community members. Treatment outcomes were much better in the treatment-supported groups compared with the control self-therapy group. CD4 cell increases were 218/µL (DOT), 267/µL (TWOT), 205/µL (WOT) versus 224/µL (SAT), whereas plasma HIV-1 RNA reached undetectable levels (<400 copies/mL) in 91%, 88%, 84% versus 79% of patients in the DOT, TWOT, WOT versus SAT groups, respectively, at 48 weeks. We, therefore, strongly support the use of treatment support in our settings.

Key Words: DIRECT OBSERVATION THERAPY • HAART • COMMUNITY SUPPORT

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