Evidence map›Paper›PMID 28074421›Full record

Trial reportAIDS and behavior2018

Community-Based Accompaniment with Supervised Antiretrovirals for HIV-Positive Adults in Peru: A Cluster-Randomized Trial.

Megan M McLaughlin, Molly F Franke, Maribel Muñoz, Adrianne K Nelson, Olga Saldaña, Janeth Santa Cruz, Milagros Wong, Zibiao Zhang, Leonid Lecca, Eduardo Ticona and 4 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in AIDS and behavior, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Dynamics of Treatment Supporters and Patients Starting HIV Therapy in Lima, Peru.Journal of the International Association of Providers of AIDS Care
    Trial
  4. Trial
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Megan M McLaughlinHarvard Medical School, Boston, MA, USA.
Molly F FrankeDepartment of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA. molly_franke@hms.harvard.edu.
Maribel MuñozSocios En Salud, Lima, Peru.
Adrianne K NelsonDepartment of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.
Olga SaldañaSocios En Salud, Lima, Peru.
Janeth Santa CruzSocios En Salud, Lima, Peru.
Milagros WongSocios En Salud, Lima, Peru.
Zibiao ZhangDivision of Global Health Equity, Brigham and Women's Hospital, Boston, MA, USA.
Leonid LeccaSocios En Salud, Lima, Peru.
Eduardo TiconaPeru Ministry of Health, Lima, Peru.
Jorge ArevaloPeru Ministry of Health, Lima, Peru.
Eduardo SanchezPeru Ministry of Health, Lima, Peru.
Jose Luis SebastiánPeru Ministry of Health, Lima, Peru.
Sonya ShinDepartment of Global Health and Social Medicine, Harvard Medical School, 641 Huntington Avenue, Boston, MA, 02115, USA.

Funding

Community-based accompaniment with supervised antiretrovirals in Lima, PeruR01MH083550 · NIMH · BRIGHAM AND WOMEN'S HOSPITAL · PI SHIN, SONYA S · 2009 to 2013
$3.3M
National Institute of Mental Health (US) R01MH083550-01A2NIMH NIH HHS R01 MH083550
6 · The paper itself

Abstract

We conducted a cluster-randomized trial to estimate effects of directly observed combination antiretroviral therapy (DOT-cART) on retention with viral suppression among HIV-positive adults in Peru. We randomly allocated facilities to receive the 12-month intervention plus the standard of care, including adherence support provided through accompaniment. In the intervention arm, health workers supervised doses, twice daily, and accompanied patients to appointments. Among 356 patients, intention-to-treat analyses showed no statistically significant benefit of DOT, relative to no-DOT, at 12 or 24 months (adjusted probability of primary outcome: 0.81 vs. 0.73 and 0.76 vs. 0.68, respectively). A statistically significant benefit of DOT was found in per-protocol and as-treated analyses at 12 months (0.83 for DOT vs. 0.73 for no DOT, p value: 0.02 per-protocol, 0.01 as-treated), but not 24 months. Rates of retention with viral suppression were high in both arms. Among adults receiving robust adherence support, the added effect of time-limited DOT, if any, is small-to-moderate.

Indexed as

Community Health ServicesDirectly Observed TherapyAdultAntiretroviral Therapy, Highly ActiveAppointments and SchedulesDelivery of Health Care, IntegratedFemaleHIV InfectionsHumansMaleMiddle AgedPeruRetention in CareSocial SupportTreatment OutcomeViral LoadAntiretroviralDirectly observed treatmentHIVTreatment support

Identifiers

PMID28074421
PMCPMC5503817

What OpenQuestion holds

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Registered trials

None linked

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.