Trial reportClinical infectious diseases : an official publication of the Infectious Diseases Society of America2011
Lack of sustained improvement in adherence or viral load following a directly observed antiretroviral therapy intervention.
Trial report in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- 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
- Interventions for enhancing medication adherence.The Cochrane database of systematic reviews · 2014Pooled it
- A systematic review of antiretroviral adherence interventions for HIV-infected people who use drugs.Current HIV/AIDS reports · 2012Pooled it
- 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
- Trial
- "Damaging what wasn't damaged already": psychological tension and antiretroviral adherence among HIV-infected methadone-maintained drug users.AIDS care · 2013Trial
- Impact of adherence counseling dose on antiretroviral adherence and HIV viral load among HIV-infected methadone maintained drug users.AIDS care · 2012Trial
- A qualitative investigation of HIV treatment dispensing models and impacts on adherence among people living with HIV who use drugs.PloS one · 2021Article
- Dispensation of antiretroviral therapy and methadone maintenance therapy at the same facility in a low-barrier setting linked to optimal adherence to HIV treatment.HIV medicine · 2019Observational
- A Multidimensional Electronic Hydroxyurea Adherence Intervention for Children With Sickle Cell Disease: Single-Arm Before-After Study.JMIR mHealth and uHealth · 2019Article
- Integrated and differentiated methadone and HIV care for people who use drugs: a qualitative study in Kenya with implications for implementation science.Health policy and planning · 2019Article
- Harnessing nanostructured systems for improved treatment and prevention of HIV disease.Bioengineering & translational medicine · 2018Review
- Developing an Integrated, Brief Biobehavioral HIV Prevention Intervention for High-Risk Drug Users in Treatment: The Process and Outcome of Formative Research.Frontiers in immunology · 2017Article
- Rationale and design of mDOT-HuA study: a randomized trial to assess the effect of mobile-directly observed therapy on adherence to hydroxyurea in adults with sickle cell anemia in Tanzania.BMC medical research methodology · 2016Article
- Finding what works: identification of implementation strategies for the integration of methadone maintenance therapy and HIV services in Vietnam.Implementation science : IS · 2016Article
- The clinical role and cost-effectiveness of long-acting antiretroviral therapy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Article
- Integrating antiretroviral therapy in methadone maintenance therapy clinics: service provider perceptions.The International journal on drug policy · 2014Article
- A comparison of modified directly observed therapy to standard care for chronic hepatitis C.Journal of community health · 2013Article
- Impact of a pharmaceutical care program on clinical evolution and antiretroviral treatment adherence: a 5-year study.Patient preference and adherence · 2013Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundMethadone clinic-based directly observed antiretroviral therapy (DOT) has been shown to be more efficacious for improving adherence and suppressing human immunodeficiency virus (HIV) load than antiretroviral self-administration. We sought to determine whether the beneficial effects of DOT remain after DOT is discontinued.
methodsWe conducted a post-trial cohort study of 65 HIV-infected opioid-dependent adults who had completed a 24-week randomized controlled trial of methadone clinic-based DOT versus treatment as usual (TAU). For 12 months after DOT discontinuation, we assessed antiretroviral adherence using monthly pill counts and electronic monitors. We also assessed viral load at 3, 6, and 12 months after DOT ended. We examined differences between DOT and TAU in (1) adherence, (2) viral load, and (3) proportion of participants with viral load of <75 copies/mL.
resultsAt trial end, adherence was higher among DOT participants than among TAU participants (86% and 54%, respectively; P < .001), and more DOT participants than TAU participants had viral loads of <75 copies/mL (71% and 44%, respectively; P = .03). However, after DOT ended, differences in adherence diminished by 1 month (55% for DOT vs 48% for TAU; P = .33) and extinguished completely by 3 months (49% for DOT vs 50% for TAU; P = .94). Differences in viral load between DOT and TAU disappeared by 3 months after the intervention, and the proportion of DOT participants with undetectable viral load decreased steadily after DOT was stopped until there was no difference (36% for DOT and 34% for TAU; P = .92).
conclusionsBecause the benefits of DOT for adherence and viral load among HIV-infected methadone patients cease after DOT is stopped, methadone-based DOT should be considered a long-term intervention.
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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.