Is Directly Observed Therapy Worthwhile in the Treatment of HIV Infection?

Adherence to antiretroviral therapy (ART) is critical for the successful treatment of HIV infection, but for a small minority of patients, it remains difficult to achieve, even with the simpler regimens now available. Some experts have proposed that directly observed therapy might improve adherence to ART, particularly among hard-to-reach populations, but others argue that such a strategy is neither acceptable nor feasible — and a recent meta-analysis of randomized controlled trials (RCTs) showed no benefit in terms of the proportion of patients achieving virologic suppression (JW Gen Med Jan 21 2010).

Now, investigators have performed a meta-analysis of 17 randomized and nonrandomized controlled studies, looking at the effects of directly o…