1269. End HIV with DOT: Maybe?. (15th December 2022)

• Record Type: Journal Article
• Authors: Garcia, Bismarck Bisono; Bengualid, Victoria; Dahdouh, Michelle; Marinello, Carla; Salazar, Hernando; Berger, Judy
• Is Part Of: Open forum infectious diseases. Volume 9:(2022)Supplement 2
• Publication Date: 2022-12-15
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofac492.1100
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Directly observed Therapy (DOT) has proven to be a valuable asset used in ascertaining adherence to tuberculosis (TB) medications, methadone, psychiatric medications and HIV medications. Both HIV and TB share the need of adherence to treatment to avoid resistance. However, unlike TB, HIV treatment must be taken for life. Argus Community (Argus DOT) provides Directly Observed Therapy to assist with medication adherence to HIV positive patients with medication adherence barriers who are not virally suppressed as long as the patient is from an affiliated medical provider network which includes St. Barnabas Designated AIDS Center (SBH DAC). Methods: SBH DAC started referring patients who have not been virally suppressed to Argus DOT March 2021 to help reach our goal of 90% virally suppressed rate (viral load < 200 copies/ml) by the end of 2021. Those who agreed to DOT were referred, accepted and enrolled in Argus. Argus DOT calls patients daily Monday to Friday to remind them to take their medications. We performed a retrospective chart review of SBH DAC/Argus DOT patients to see if this intervention improved our suppression rate from March 2021 to December 2021 and if there were any barriers for our patients in regards to receiving these benefits. Results: 18 patients were approached by the DAC team to enroll in Argus DOT; of those 15 originally agreed to the program. 3 patients declined the enrollment. Of the 15 patients who agreed to the program, 6 patients discontinued the program and none of these 6 patients achieved viral load suppression. Results of 9 patients who stayed with Argus DOT: 8 out of 9 patients achieved a viral load < 200 copies/ml and one achieved 230 copies/ml from 2200 copies/ml. 2 patients achieve a viral load < 20 copies/ml (undetectable). Conclusion: This small study shows Argus DOT as valuable asset in achieving decrease HIV viral load in patients with medication adherence barriers. 50% accepting and staying with the program achieved 89% viral suppression; close to the 90% needed to End the Epidemic. 9 out of 18 who did not agree or discontinued Argus DOT due to uncontrolled psychiatric, substance use, nonworking phones and distrust did not achieve viral suppression. Co-located psychiatric, substance use as well as in-house SBH DOT personnel is needed to achieve viral load suppression. Disclosures: All Authors : No reported disclosures.