AIDS and Behavior

, Volume 14, Issue 3, pp 721–730

Community-based DOT-HAART Accompaniment in an Urban Resource-Poor Setting


  • Maribel Muñoz
    • Socios En Salud Sucursal Perú
  • Karen Finnegan
    • Rollins School of Public HealthEmory University
  • Jhon Zeladita
    • Socios En Salud Sucursal Perú
  • Adolfo Caldas
    • Division of Global Health EquityBrigham and Women’s Hospital
  • Eduardo Sanchez
    • Hospital Nacional Hipólito Unanue
  • Miriam Callacna
    • Hospital Nacional Hipólito Unanue
  • Christian Rojas
    • Hospital Nacional Hipólito Unanue
  • Jorge Arevalo
    • Hospital Dos de Mayo
  • Jose Luis Sebastian
    • Peruvian HIV ProgramMinisterio de Salud
  • Cesar Bonilla
    • Peruvian TB ProgramMinisterio de Salud
  • Jaime Bayona
    • Socios En Salud Sucursal Perú
    • Socios En Salud Sucursal Perú
    • Division of Global Health EquityBrigham and Women’s Hospital
    • Harvard Medical School
Original Paper

DOI: 10.1007/s10461-009-9559-5

Cite this article as:
Muñoz, M., Finnegan, K., Zeladita, J. et al. AIDS Behav (2010) 14: 721. doi:10.1007/s10461-009-9559-5


From December 2005 to April 2007, we enrolled 60 adults starting antiretroviral therapy (ART) in a health district of Lima, Peru to receive community-based accompaniment with supervised antiretroviral (CASA). Paid community health workers performed twice-daily home visits to directly observe ART and offered additional medical, social and economic support to CASA participants. We matched 60 controls from a neighboring district by age, CD4 and primary referral criteria (TB status, female, neither). Using validated instruments at baseline and 12 months (time of DOT-HAART completion) we measured depression, social support, quality of life, HIV-related stigma and self-efficacy. We compared 12 month clinical and psychosocial outcomes among CASA versus control groups. CASA participants experienced better clinical and psychosocial outcomes at 12 months, including proportion with virologic suppression, increase in social support and reduction in HIV-associated stigma.


AdherenceHIVResource-poor settingPovertyDOT-HAART

Copyright information

© Springer Science+Business Media, LLC 2009