ArticleAIDS research and human retroviruses2010
Directly observed therapy (DOT) for nonadherent HIV-infected youth: lessons learned, challenges ahead.
Article in AIDS research and human retroviruses, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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The trial behind it
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Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Challenges in the Evaluation of Interventions to Improve Engagement Along the HIV Care Continuum in the United States: A Systematic Review.AIDS and behavior · 2017Pooled it
- Antiretroviral Therapy Adherence Enhancing Interventions for Adolescents and Young Adults 13-24 Years of Age: A Review of the Evidence Base.Journal of acquired immune deficiency syndromes (1999) · 2016Pooled it
- Service delivery interventions to improve adolescents' linkage, retention and adherence to antiretroviral therapy and HIV care.Tropical medicine & international health : TM & IH · 2015Pooled it
- Positive STEPS: Enhancing Medication Adherence and Achieving Viral Load Suppression in Youth Living With HIV in the United States-Results From an Efficacious Stepped Care, Randomized Controlled Trial.Journal of acquired immune deficiency syndromes (1999) · 2025Trial
- An Adaptive Antiretroviral Therapy Adherence Intervention for Youth with HIV Through Text Message and Cell Phone Support with and without Incentives: A Sequential Multiple Assignment Randomized Trial (SMART).AIDS and behavior · 2025Trial
- Randomized Controlled Trial of a Remote Coaching mHealth Adherence Intervention in Youth Living with HIV.AIDS and behavior · 2022Trial
- Effect of varenicline directly observed therapy versus varenicline self-administered therapy on varenicline adherence and smoking cessation in methadone-maintained smokers: a randomized controlled trial.Addiction (Abingdon, England) · 2021Trial
- Positive STEPS - a randomized controlled efficacy trial of an adaptive intervention for strengthening adherence to antiretroviral HIV treatment among youth: study protocol.BMC public health · 2018Trial
- Acceptability and Feasibility of a Cell Phone Support Intervention for Youth Living with HIV with Nonadherence to Antiretroviral Therapy.AIDS patient care and STDs · 2015Trial
- The use of cell phone support for non-adherent HIV-infected youth and young adults: an initial randomized and controlled intervention trial.AIDS and behavior · 2014Trial
- Article
- Improving Treatment Adherence in Youths With Multidrug-Resistant Tuberculosis With Psychosocial Intervention.Brain and behavior · 2025Article
- Feasibility of smartphone-enabled asynchronous video directly observed therapy to improve viral suppression outcomes among HIV unsuppressed children and adolescents in Kenya.BMC infectious diseases · 2025Article
- Modeling Adherence Interventions Among Youth with HIV in the United States: Clinical and Economic Projections.AIDS and behavior · 2021Article
- The effects of family, society and national policy support on treatment adherence among newly diagnosed tuberculosis patients: a cross-sectional study.BMC infectious diseases · 2020Article
- Adaptive Antiretroviral Therapy Adherence Interventions for Youth Living With HIV Through Text Message and Cell Phone Support With and Without Incentives: Protocol for a Sequential Multiple Assignment Randomized Trial (SMART).JMIR research protocols · 2018Article
- Network support, technology use, depression, and ART adherence among HIV-positive MSM of color.AIDS care · 2017Article
- Article
- Reaching the unreached: treatment as prevention as a workable strategy to mitigate HIV and its consequences in high-risk groups.Current HIV/AIDS reports · 2014Review
- Adaptation of an HIV Medication Adherence Intervention for Adolescents and Young Adults.Cognitive and behavioral practice · 2014Article
Corrections and comments
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Authors and funding
11 authors at 8 institutions in 1 country.
Funding
Abstract
Adherence to medications is critical to optimizing HIV care and is a major challenge in youth. The utility of directly observed therapy (DOT) to improve adherence in youth with HIV remains undefined and prompted this pilot study. Four U.S. sites were selected for this 24-week cooperative group study to assess feasibility and to identify the logistics of providing DOT to HIV-infected youth with demonstrated adherence problems. Once-a-day DOT was provided by DOT facilitators at the participant's choice of a community-based location and DOT tapered over 12 weeks to self-administered therapy based on ongoing adherence assessments. Twenty participants, median age 21 years and median CD4 227 cells/microl, were enrolled. Participants chose their homes for 82% of DOT visits. Compliance with recommended DOT visits was (median) 91%, 91%, and 83% at weeks 4, 8, and 12, respectively. Six participants completed >90% of the study-specified DOT visits and successfully progressed to self-administered therapy (DOT success); only half sustained >90% medication adherence 12 weeks after discontinuing DOT. Participants considered DOT successes were more likely to have higher baseline depression scores (p = 0.046). Via exit surveys participants reported that meeting with the facilitator was easy, DOT increased their motivation to take medications, they felt sad when DOT ended, and 100% would recommend DOT to a friend. In conclusion, this study shows that while community-based DOT is safe, feasible, and as per participant feedback, acceptable to youth, DOT is not for all and the benefits appear short-lived. Depressed youth appear to be one subgroup that would benefit from this intervention. Study findings should help inform the design of larger community-based DOT intervention studies in youth.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.