DO ART (DELIVERY OPTIMIZATION OF ANTIRETROVIRAL THERAPY)

Details

• Description:
  Delivery Optimization of Antiretroviral Therapy (DO ART) is a community-level antiretroviral therapy (ART) intervention for people with HIV (PWH) in South Africa and Uganda to increase viral suppression. Two interventions were evaluated against standard clinic ART delivery: (1) community-based ART initiation with quarterly monitoring and ART refills through mobile vans and (2) a hybrid approach that consisted of ART initiation at a clinic site followed by mobile van monitoring and refills. Participants in the community-based ART group receive same-day ART initiation including standardized counseling and the national HIV program’s regimen of ART. Seven days after ART initiation, participants receive a call asking about symptoms, side effects, and adverse events. Participants return to a mobile van parked at a known location and scheduled time for five in-person follow-up visits at 1, 3, 6, 9 and 12 months for ART resupply, clinical monitoring, counseling, and ascertainment of adverse events and social harms. Participants receive an automated text message reminder the week before their visit is due to schedule appointments for their mobile van visits. Participants can reschedule visits by text message, request additional ART if traveling, and nominate someone else to collect their medication. Participants who missed appointments are contacted and their visit is rescheduled. The mobile phone service is regularly available on evenings and weekends and an application is used for standardized monitoring. For HIV and ART monitoring, participants complete a clinical questionnaire to screen for symptoms of ART adverse events, TB, and other common opportunistic infections. HIV plasma viral load is assessed for treatment success at month 6. Participants also receive individualized adherence support. Participants who require additional clinical services are referred to care and followed until they are linked to a clinic. Participants in the hybrid group are counseled to notify the study team once they initiate ART at the clinic to facilitate transition to the community for refills and monitoring. Until notification of ART initiation, they receive quarterly phone calls to inquire whether they have initiated ART and record adverse events. Once participants initiate ART at the clinic, they follow the identical procedures described above for the community-based ART delivery group.
• Document Type:
  Report
• CIO:
  NCHHSTP
• Division:
  NCHHSTP_DHAP
• Topic:
  PRS Project HIV Compendium
• Collection(s):
  Historical CDC.gov Content
• Main Document Checksum:
  urn:sha256:f49ce192b16c2ccd972a92acec1938994dede25db6227786adc7248d1211c78b
• Download URL:
  https://stacks.cdc.gov/view/cdc/149585/cdc_149585_DS1.pdf
• File Type:
  [PDF - 343.59 KB ]