The feasibility of modified directly observed therapy for HIV-seropositive African American substance users
The feasibility of modified directly observed therapy for HIV-seropositive African American substance users
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DOI：
10.1089/apc.2007.0063
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发表时间：
2008-02-01
影响因子：
4.9
通讯作者：
Mitty, Jennifer A.
中科院分区：
文献类型：
--
作者：
Mindy, M. A.;Brown, Billy R.;Mitty, Jennifer A.
最近，改良的直接观察疗法(MDOT)已经成为一种很有前途的干预措施，可以解决难以接触到的艾滋病毒感染人群的不依从性。到目前为止，还没有专门针对非裔美国人的MDOT数据。本研究试图在南方31名艾滋病毒血清阳性的非裔美国人药物使用者中确定MDOT的可行性。一名外展工作人员观察参与者每周5天(每天一次)的药物摄入量，为期3个月(密集阶段)。这一阶段之后是一个为期3个月的过渡期，在此期间，MDOT的频率逐渐减少，从5天减少到每周一次。在基线、3个月和6个月进行评估，以收集人口统计学信息、艾滋病毒危险行为、药物使用、抑郁和服药依从性。结果表明，与基线相比，更多的参与者坚持他们的药物治疗方案，在3个月和6个月时病毒载量低于每毫升400个拷贝。与基线和3个月相比，参与者在6个月的评估中报告的抑郁症状明显减少。在可接受性方面，95%的参与者表示他们喜欢外展访问，100%的人报告MDOT帮助他们服药，只有5%的人认为MDOT侵犯了隐私。这些结果表明，MDOT在南方非裔美国人药物使用者中是可行的，有必要在这一人群中进行更大规模的MDOT对照研究。
Recently, modified directly observed therapy (MDOT) has emerged as a promising intervention to address nonadherence for hard-to-reach populations infected with HIV. To date, there are no existing data on MDOT focusing exclusively on African Americans. The present study sought to determine the feasibility of MDOT among 31 HIV-seropositive African American substance users in the South. An outreach worker observed the participants' medication intake 5 days per week (once per day) for a period of 3 months (intensive phase). This phase was followed by a transition phase of 3 months during which the frequency of MDOT was gradually tapered from 5 days to once weekly. Assessments to gather demographic information, HIV risk behaviors, substance use, depression, and medication adherence were conducted at baseline, 3 months, and 6 months. Results indicated that more participants adhered to their medication regimen and had viral loads of less than 400 copies per milliliter at 3 and 6 months compared to baseline. Participants reported significantly less depressive symptoms at the 6-month assessment compared to baseline and 3 months. With regard to acceptability, 95% of participants indicated they liked having the outreach visits, 100% reported MDOT helped them take their medications, and only 5% felt MDOT was a violation of privacy. These results suggest MDOT is feasible among African American substance users in the South and a larger controlled study of MDOT with this population is warranted.