A principal concern of antiretroviral therapy (ART) programs is the ability of clients to maintain a high level of adherence to medication. Based on formative research conducted with HIV-infected clients and health workers in Mombasa, Kenya, and lessons learned from directly observed therapy strategies to encourage adherence to treatment for tuberculosis, a directly administered antiretroviral therapy (DAART) strategy to promote adherence to ART was developed. This study examines whether the intervention was more effective in fostering adherence to ART than standard follow-up among people living with HIV in Mombasa. Researchers from the Horizons Program and the International Centre for Reproductive Health conducted a randomized controlled two-arm study to determine the short- and longer-term effects of DAART compared to standard care. DAART was found to be more effective in promoting adherence during the 24-week intervention period than standard care, but the effect was not sustained postintervention. As noted in this brief, results suggest that DAART is effective for improving adherence in this setting, but the optimal length of the intervention for sustaining adherence and its transition to standard care may warrant further research.
Sarna, Avina, Stanley Luchters, Scott Geibel, Matthew F. Chersich, Paul Munyao, Rick Homan, Susan Kaai, Kishorchandra N. Mandaliya, Marleen Temmerman, and Naomi Rutenberg. 2007. "Promoting adherence through a directly administered antiretroviral therapy strategy in Mombasa, Kenya," Horizons Research Summary. Nairobi: Population Council.