Enhancing adherence to antiretroviral therapy at the XXXX clinic in resource constrained countries; the Tanzanian experience.

@entity1 @entity404 @entity645
OBJECTIVE: To evaluate various strategies aimed at improving adherence to antiretroviral therapy (ART). METHODS: @entity1 initiated on ART at Muhimbili National Hospital @entity645 clinic were randomly assigned to either regular adherence counseling, regular counseling plus a calendar, or regular counseling and a treatment assistant. @entity1 were seen monthly; during these meetings self-reported adherence to treatment was recorded. Disease progression was monitored clinically and immunologically. RESULTS: Of the 621 @entity1 randomized, 312 received regular counseling only, 242 regular counseling and calendars, while 67 had treatment assistants in addition to regular counseling. The mean (SD) follow-up time was 14.5 (4.6) months. During follow-up 20 (3.2%) @entity1 died, and 102 (16.4%) were lost to follow-up; this was similar in all groups. In 94.8% of all visits, @entity1 reported to have adhered to treatment. In only 39 (0.7%) visits did @entity1 report a < or = 95% adherence. There were no differences in adherence (P = 0.573) or differences in @entity404 count and weight changes over time in the interventions. CONCLUSIONS: Good adherence to ART is possible in resource constrained countries. Persistent adherence counseling in clinic settings by itself may be effective in improving adherence to ART.
