Open AccessCommunity-based DOT-HAART Accompaniment in an Urban Resource-Poor Setting
Author(s) -
Maribel Muñoz,
Karen Finnegan,
Jhon Zeladita,
Adolfo Caldas,
Eduardo Sánchez,
Miriam Callacna,
Christian Rojas,
Jorge Arévalo,
J.L. Sebastián,
César Bonilla,
Jaime Bayona,
Sonya Shin
Publication year - 2009
Publication title -
aids and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.994
H-Index - 106
eISSN - 1573-3254
pISSN - 1090-7165
DOI - 10.1007/s10461-009-9559-5
Subject(s) - psychosocial , referral , stigma (botany) , social support , medicine , public health , health psychology , quality of life (healthcare) , social stigma , depression (economics) , gerontology , psychiatry , family medicine , human immunodeficiency virus (hiv) , psychology , nursing , economics , psychotherapist , macroeconomics
From December 2005 to April 2007, we enrolled 60 adults starting antiretroviral therapy (ART) in a health district of Lima, Peru to receive community-based accompaniment with supervised antiretroviral (CASA). Paid community health workers performed twice-daily home visits to directly observe ART and offered additional medical, social and economic support to CASA participants. We matched 60 controls from a neighboring district by age, CD4 and primary referral criteria (TB status, female, neither). Using validated instruments at baseline and 12 months (time of DOT-HAART completion) we measured depression, social support, quality of life, HIV-related stigma and self-efficacy. We compared 12 month clinical and psychosocial outcomes among CASA versus control groups. CASA participants experienced better clinical and psychosocial outcomes at 12 months, including proportion with virologic suppression, increase in social support and reduction in HIV-associated stigma.