From directly observed therapy to Accompagnateurs:: Enhancing AIDS treatment outcomes in Haiti and in Boston
From directly observed therapy to Accompagnateurs:: Enhancing AIDS treatment outcomes in Haiti and in Boston
复制标题
DOI：
10.1086/421408
复制
发表时间：
2004-06-01
影响因子：
11.8
通讯作者：
Mukherjee, JS
中科院分区：
文献类型：
--
作者：
Behforouz, HL;Farmer, PE;Mukherjee, JS
与结核病一样，人类免疫缺陷病毒(HIV)疾病与贫困和社会不平等有关，这些情况阻碍了医疗服务的提供。与结核病一样，艾滋病毒感染的治疗需要多种药物方案，病原体获得抗药性，并可能传播给其他人。海地农村的一个试点项目引入了DOT-HAART(高效抗逆转录病毒疗法的直接观察疗法)，用于护理晚期获得性免疫缺陷综合征患者。波士顿也启动了类似的DOT-HAART努力，用于经历无监督治疗失败的抗药性艾滋病毒疾病患者。在这两种情况下，社区健康促进者或同伴提供的不仅仅是DOT：他们提供心理社会支持，并将患者与临床工作人员和可用的资源联系起来。这两种情况下的Dot-HAART既带来了挑战，也带来了机遇。这些护理模式可以适用于资源匮乏环境中的其他贫困人口。
Like tuberculosis, human immunodeficiency virus (HIV) disease is associated with poverty and social inequalities, conditions that hamper the delivery of care. Like tuberculosis, treatment of HIV infection requires multidrug regimens, and the causative agent acquires drug resistance, which can be transmitted to others. A pilot project in rural Haiti introduced DOT-HAART (directly observed therapy with highly active antiretroviral therapy) for the care of patients with advanced acquired immune deficiency syndrome. A similar DOT-HAART effort was launched in Boston for patients with drug-resistant HIV disease who had experienced failure of unsupervised therapy. In both settings, community health promoters or accompagnateurs provide more than DOT: they offer psychosocial support and link patients to clinical staff and available resources. DOT-HAART in these 2 settings presents both challenges and opportunities. These models of care can be applied to other poverty-stricken populations in resource-poor settings.