Study design and participant characteristics of a randomized controlled trial of directly administered antiretroviral therapy in opioid treatment programs

Bernadette A. Mullen, Katie Cook, Richard D Moore, Cynthia S Rand, Noya Galai, Mary Elizabeth McCaul, Sheldon Glass, Krisann K. Oursler, Gregory M Lucas

Research output: Contribution to journalArticle

Abstract

Background: HIV-infected drug users are at higher risk of non-adherence and poor treatment outcomes than HIV-infected non-drug users. Prior work from our group and others suggests that directly administered antiretroviral therapy (DAART) delivered in opioid treatment programs (OTPs) may increase rates of viral suppression.Methods/Design: We are conducting a randomized trial comparing DAART to self-administered therapy (SAT) in 5 OTPs in Baltimore, Maryland. Participants and investigators are aware of treatment assignments. The DAART intervention is 12 months. The primary outcome is HIV RNA <50 copies/mL at 3, 6, and 12 months. To assess persistence of any study arm differences that emerge during the active intervention, we are conducting an 18-month visit (6 months after the intervention concludes). We are collecting electronic adherence data for 2 months in both study arms. Of 457 individuals screened, a total of 107 participants were enrolled, with 56 and 51 randomly assigned to DAART and SAT, respectively. Participants were predominantly African American, approximately half were women, and the median age was 47 years. Active use of cocaine and other drugs was common at baseline. HIV disease stage was advanced in most participants. The median CD4 count at enrollment was 207 cells/mm3, 66 (62%) had a history of an AIDS-defining opportunistic condition, and 21 (20%) were antiretroviral naïve.Conclusions: This paper describes the rationale, methods, and baseline characteristics of subjects enrolled in a randomized clinical trial comparing DAART to SAT in opioid treatment programs.Trial Registration: ClinicalTrials.gov: NCT00279110.

Original languageEnglish (US)
Article number45
JournalBMC Infectious Diseases
Volume11
DOIs
StatePublished - Feb 15 2011

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Opioid Analgesics
Randomized Controlled Trials
Therapeutics
HIV
Baltimore
CD4 Lymphocyte Count
Drug Users
Cocaine
African Americans
Acquired Immunodeficiency Syndrome
Research Personnel
RNA

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

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abstract = "Background: HIV-infected drug users are at higher risk of non-adherence and poor treatment outcomes than HIV-infected non-drug users. Prior work from our group and others suggests that directly administered antiretroviral therapy (DAART) delivered in opioid treatment programs (OTPs) may increase rates of viral suppression.Methods/Design: We are conducting a randomized trial comparing DAART to self-administered therapy (SAT) in 5 OTPs in Baltimore, Maryland. Participants and investigators are aware of treatment assignments. The DAART intervention is 12 months. The primary outcome is HIV RNA <50 copies/mL at 3, 6, and 12 months. To assess persistence of any study arm differences that emerge during the active intervention, we are conducting an 18-month visit (6 months after the intervention concludes). We are collecting electronic adherence data for 2 months in both study arms. Of 457 individuals screened, a total of 107 participants were enrolled, with 56 and 51 randomly assigned to DAART and SAT, respectively. Participants were predominantly African American, approximately half were women, and the median age was 47 years. Active use of cocaine and other drugs was common at baseline. HIV disease stage was advanced in most participants. The median CD4 count at enrollment was 207 cells/mm3, 66 (62{\%}) had a history of an AIDS-defining opportunistic condition, and 21 (20{\%}) were antiretroviral na{\"i}ve.Conclusions: This paper describes the rationale, methods, and baseline characteristics of subjects enrolled in a randomized clinical trial comparing DAART to SAT in opioid treatment programs.Trial Registration: ClinicalTrials.gov: NCT00279110.",
author = "Mullen, {Bernadette A.} and Katie Cook and Moore, {Richard D} and Rand, {Cynthia S} and Noya Galai and McCaul, {Mary Elizabeth} and Sheldon Glass and Oursler, {Krisann K.} and Lucas, {Gregory M}",
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AU - Cook, Katie

AU - Moore, Richard D

AU - Rand, Cynthia S

AU - Galai, Noya

AU - McCaul, Mary Elizabeth

AU - Glass, Sheldon

AU - Oursler, Krisann K.

AU - Lucas, Gregory M

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N2 - Background: HIV-infected drug users are at higher risk of non-adherence and poor treatment outcomes than HIV-infected non-drug users. Prior work from our group and others suggests that directly administered antiretroviral therapy (DAART) delivered in opioid treatment programs (OTPs) may increase rates of viral suppression.Methods/Design: We are conducting a randomized trial comparing DAART to self-administered therapy (SAT) in 5 OTPs in Baltimore, Maryland. Participants and investigators are aware of treatment assignments. The DAART intervention is 12 months. The primary outcome is HIV RNA <50 copies/mL at 3, 6, and 12 months. To assess persistence of any study arm differences that emerge during the active intervention, we are conducting an 18-month visit (6 months after the intervention concludes). We are collecting electronic adherence data for 2 months in both study arms. Of 457 individuals screened, a total of 107 participants were enrolled, with 56 and 51 randomly assigned to DAART and SAT, respectively. Participants were predominantly African American, approximately half were women, and the median age was 47 years. Active use of cocaine and other drugs was common at baseline. HIV disease stage was advanced in most participants. The median CD4 count at enrollment was 207 cells/mm3, 66 (62%) had a history of an AIDS-defining opportunistic condition, and 21 (20%) were antiretroviral naïve.Conclusions: This paper describes the rationale, methods, and baseline characteristics of subjects enrolled in a randomized clinical trial comparing DAART to SAT in opioid treatment programs.Trial Registration: ClinicalTrials.gov: NCT00279110.

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