From December 2005 to April 2007, we enrolled 60 adults starting antiretroviral therapy (ART) in Lima, Peru to receive community-based accompaniment with supervised antiretrovirals (CASA), consisting of 12 months of DOT-HAART, as well as microfinance assistance and/or psychosocial support group according to individuals' need. We matched 60 controls from a neighboring district, and assessed final clinical and psychosocial outcomes at 24 months. CASA support was associated with higher rates of virologic suppression and lower mortality. A comprehensive, tailored adherence intervention in the form of community-based DOT-HAART and matched economic and psychosocial support is both feasible and effective for certain individuals in resource-poor settings.
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Acknowledgements We would like to acknowledge the Office for AIDS Research at the National Institutes for Health; the Eleanor and Miles Shore Fellowship at Harvard Medical School; David Rockefeller Center for Latin American Studies at Harvard University, and Partners In Health for support of this project. We also thank Christian Rojas, Miriam Callacna, Julio Acha, Humberto Castillo, Eduardo Rodriguez, and Mayler Albujar for their efforts with the intervention. No conflicts of interest exist.
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- Resource-poor setting