Directly Observed versus Self-administered Antiretroviral Therapies: Preference of HIV-Positive Jailed Inmates in San Francisco

Abstract

Directly observed therapy (DOT) of antiretroviral (ARV) medications has beneficial effects on HIV treatment for incarcerated inmates but has been associated with limited continuation after release and inadvertent disclosure of HIV status. Guided self-administered therapy (g-SAT) may be a preferred method of ARV delivery and may encourage medication-taking behavior. We surveyed the preference of 102 HIV-positive jailed inmates at the San Francisco City and County Jails regarding receiving ARVs via DOT versus g-SAT while incarcerated. Participants overwhelmingly preferred g-SAT over DOT.

Client Acceptability for Integrating Antiretroviral Therapy in Methadone Maintenance Therapy Clinics in Sichuan, China

“…Nonetheless, the lack of confidentiality and conflict with self-dosing habits poses a major concern, which reduces the feasibility of delivering this service to MMT clinics. Similar findings have also been reported in other studies (Saberi, Caswell, Jamison, Estes, & Tulsky, 2012; Wohl et al, 2003). Instead of imposing this type of service on the client, the provider should change tactics by informing the clients of the importance of treatment adherence, providing the clients with specific medication instructions, introducing mobile applications to support adherence, and guiding the client to establish a medication-taking routine.…”

Optimization of Human Immunodeficiency Virus Treatment During Incarceration

“…Patient and health care provider preferences likely also play a role in DOT selection in that patients may opt against DOT because of concerns about inadvertent disclosure of HIV status, 39 and health care providers may triage patients for DOT who they perceive as being nonadherent. 40 Alternatively, DOT may have limited additional benefit when ART regimens are well tolerated and provided within a highly structured correctional setting, where patients have considerable access to psychiatric medications and less access to mind-altering substances like alcohol or drugs that are all associated with decreased adherence. 12,41,42 In community settings, however, DOT has a clearly documented beneficial effect on HIV treatment outcomes for certain populations, especially those with SUDs and among released prisoners.…”

HIV/aids no cárcere: desafios relacionados à regularidade no uso da terapia antirretroviral

“…; CULBERT et al (2016); PAPARIZOS, et al (2013); SHALIHU et al (2014); PETERSON et al (2015); MEYER et al (2014).SegundoBingham (2012), em estudo realizado nos Estados Unidos, a disponibilização de um profissional específico (farmacêutico) para proceder ao gerenciamento das medicações, bem como fornecer orientações sobre as mesmas possibilitou que alguns pacientes melhorassem seus marcadores clínicos como a carga viral e CD4+ (BINGHAM, J.T, 2012). Outro estudo realizado em São Francisco (EUA) analisou a preferência dos detentos em relação ao seguimento utilizando a terapia diretamente observada (DAART) e a auto administrada guiada, de modo que a maioria aponta opção pela modalidade auto administrada, justificada pela privacidade, maior controle do antirretroviral e diminuição de outros problemas(SABERI et al, 2012). A modalidade em questão favoreceu a tendência ao autocuidado e a adesão terapêutica(SABERI et al, 2012).…”

“…Outro estudo realizado em São Francisco (EUA) analisou a preferência dos detentos em relação ao seguimento utilizando a terapia diretamente observada (DAART) e a auto administrada guiada, de modo que a maioria aponta opção pela modalidade auto administrada, justificada pela privacidade, maior controle do antirretroviral e diminuição de outros problemas(SABERI et al, 2012). A modalidade em questão favoreceu a tendência ao autocuidado e a adesão terapêutica(SABERI et al, 2012).…”