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To the Editor: The efficacy of highly active antiretroviral therapy (HAART) in the treatment of human immunodeficiency virus (HIV) infection has been demonstrated in a number of clinical reports.¹ However, current regimens are complex and poor adherence to therapy is the main cause of both treatment failure and emergence of drug resistance.² Adherence to multidose treatment regimens may be more difficult in certain settings, such as prison.³ Herein we report data from HIV-positive prisoners treated using a directly observed therapy (DOT) program.⁴ To our knowledge, DOT for HIV infection has not been evaluated in this setting.

Methods

We selected 9 Italian prisons in which antiretroviral drugs are always administered by prison nurses who observe the patient taking every dose (DOT schedule), and 9 prisons in which nurses leave all drugs with the patient once a day with no directly observed control (NDOT schedule). Eighty-four HIV-infected intravenous drug users were consecutively enrolled . . . [Full Text of this Article]

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