AIDS and Behavior

, Volume 15, Issue 7, pp 1454–1464 | Cite as

Matching Social Support to Individual Needs: A Community-Based Intervention to Improve HIV Treatment Adherence in a Resource-Poor Setting

  • Maribel Muñoz
  • Jaime Bayona
  • Eduardo Sanchez
  • Jorge Arevalo
  • Jose Luis Sebastian
  • Fernando Arteaga
  • Dalia Guerra
  • Jhon Zeladita
  • Betty Espiritu
  • Milagros Wong
  • Adolfo Caldas
  • Sonya Shin
Original Paper


From December 2005 to April 2007, we enrolled 60 adults starting antiretroviral therapy (ART) in Lima, Peru to receive community-based accompaniment with supervised antiretrovirals (CASA), consisting of 12 months of DOT-HAART, as well as microfinance assistance and/or psychosocial support group according to individuals’ need. We matched 60 controls from a neighboring district, and assessed final clinical and psychosocial outcomes at 24 months. CASA support was associated with higher rates of virologic suppression and lower mortality. A comprehensive, tailored adherence intervention in the form of community-based DOT-HAART and matched economic and psychosocial support is both feasible and effective for certain individuals in resource-poor settings.


Adherence HIV Resource-poor setting Poverty DOT-HAART 



We would like to acknowledge the Office for AIDS Research at the National Institutes for Health; the Eleanor and Miles Shore Fellowship at Harvard Medical School; David Rockefeller Center for Latin American Studies at Harvard University, and Partners In Health for support of this project. We also thank Christian Rojas, Miriam Callacna, Julio Acha, Humberto Castillo, Eduardo Rodriguez, and Mayler Albujar for their efforts with the intervention. No conflicts of interest exist.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Maribel Muñoz
    • 1
  • Jaime Bayona
    • 1
  • Eduardo Sanchez
    • 2
  • Jorge Arevalo
    • 3
  • Jose Luis Sebastian
    • 4
  • Fernando Arteaga
    • 1
  • Dalia Guerra
    • 1
  • Jhon Zeladita
    • 1
  • Betty Espiritu
    • 1
  • Milagros Wong
    • 1
  • Adolfo Caldas
    • 5
  • Sonya Shin
    • 5
    • 6
  1. 1.Socios En Salud Sucursal PerúLimaPeru
  2. 2.Hospital Nacional Hipólito UnanueLimaPeru
  3. 3.Hospital Dos de MayoLimaPeru
  4. 4.Peruvian HIV ProgramMinisterio de SaludLimaPeru
  5. 5.Division of Global Health EquityBrigham and Women’s HospitalBostonUSA
  6. 6.Harvard Medical SchoolBostonUSA

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