Document Detail

A pilot study of food supplementation to improve adherence to antiretroviral therapy among food-insecure adults in Lusaka, Zambia.
MedLine Citation:
PMID:  18769349     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The provision of food supplementation to food-insecure patients initiating antiretroviral therapy (ART) may improve adherence to medications.
METHODS: A home-based adherence support program at 8 government clinics assessed patients for food insecurity. Four clinics provided food supplementation, and 4 acted as controls. The analysis compared adherence (assessed by medication possession ratio), CD4, and weight gain outcomes among food-insecure patients enrolled at the food clinics with those enrolled at the control clinics.
RESULTS: Between May 1, 2004, and March 31, 2005, 636 food- insecure adults were enrolled. Food supplementation was associated with better adherence to therapy. Two hundred fifty-eight of 366 (70%) patients in the food group achieved a medication possession ratio of 95% or greater versus 79 of 166 (48%) among controls (relative risk = 1.5; 95% confidence interval: 1.2 to 1.8). This finding was unchanged after adjustment for sex, age, baseline CD4 count, baseline World Health Organization stage, and baseline hemoglobin. We did not observe a significant effect of food supplementation on weight gain or CD4 cell response.
CONCLUSIONS: This analysis suggests that providing food to food-insecure patients initiating ART is feasible and may improve adherence to medication. A large randomized study of the clinical benefits of food supplementation to ART patients is urgently needed to inform international policy.
Ronald A Cantrell; Moses Sinkala; Karen Megazinni; Sibi Lawson-Marriott; Sierra Washington; Benjamin H Chi; Bushimbwa Tambatamba-Chapula; Jens Levy; Elizabeth M Stringer; Lloyd Mulenga; Jeffrey S A Stringer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Journal of acquired immune deficiency syndromes (1999)     Volume:  49     ISSN:  1525-4135     ISO Abbreviation:  J. Acquir. Immune Defic. Syndr.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-29     Completed Date:  2008-10-31     Revised Date:  2013-12-27    
Medline Journal Info:
Nlm Unique ID:  100892005     Medline TA:  J Acquir Immune Defic Syndr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  190-5     Citation Subset:  IM; X    
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MeSH Terms
Antiretroviral Therapy, Highly Active*
CD4 Lymphocyte Count
Communicable Disease Control / methods*
Dietary Supplements
Food, Fortified* / supply & distribution
HIV Infections / drug therapy*
Pilot Projects
Treatment Outcome
Treatment Refusal*
Weight Gain
Grant Support
D43 TW 001035/TW/FIC NIH HHS; D43 TW001035/TW/FIC NIH HHS; K01 TW 05708/TW/FIC NIH HHS; K01 TW 06670/TW/FIC NIH HHS

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