HIV/AIDS Clinical Trial
Official title:
Directly Observed Therapy for Community-Released HIV+ Prisoners
The aim of this study is to develop effective interventions for HIV-infected prisoners who
are released to the community. The intervention that we will study will be directly observed
therapy (DAART/DOT) and we will compare this to the current standard of care that involves
self-administered therapy (SAT). All subjects will get transitional case management and all
subjects with a prior history of opiate dependence will be offered opiate substitution
therapy (buprenorphine or methadone).
Hypotheses:
- At the end of six months those receiving DAART will have a higher level of adherence to
HAART as compared to the SAT group.
- The DAART Intervention will result in subjects having lower viral loads and higher CD4
counts as compared to the SAT group.
- At the end of six months, the DAART group will have a lower rate of recidivism to
jail/prison as compared to the SAT group.
- Over the year, the DAART group will be more likely to make repeated primary HIV care
visits than the SAT group.
Any individual that is HIV positive and incarcerated for at least a period of 90 days and on
antiretroviral medications would be referred to the study by the medical staff of the
incarceration facilities prior to release or within 30 days of release an individual would
be able to self refer.
Subjects would be screened and consented and interviewed prior to their release from
incarceration, on their day of release, and monthly for a period of one year. At the time of
their day of release interview, subjects are randomized to either the intervention DAART
group or the standard of care SAT group. All subjects would be assessed and offered opiate
substitution therapy if there was a prior history of opiate dependency as a means of relapse
prevention.
Subjects in DAART would be seen everyday for a period of six months by a team of research
assistants who observe the subjects taking their medications, and their last six months
would be done as standard of care. Standard of care SAT subjects would continue to take
their medications on their own as prescribed. All subjects would be interviewed monthly and
quarterly would have laboratory blood tests completed.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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