Coping With HIV/AIDS in Tanzania

坦桑尼亚应对艾滋病毒/艾滋病

基本信息

批准号：
8324712
负责人：
KATHRYN WHETTEN
金额：
$ 55.48万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-06 至 2014-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8324712
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Adult Adverse effects Africa South of the Sahara Aftercare Age Antiretroviral drug resistance Anxiety Appointment Area Bed Occupancy Belief CD4 Lymphocyte Count Caregivers Caring Case Manager Characteristics Child Care Clinic Clinical Data Cohort Studies Communicable Diseases Counseling Country Cross-Sectional Studies Data Data Analyses Data Collection Deltastab Diagnosis Disease Disease Progression Economic Factors Economics Education Emergency Situation Enrollment Ensure Ethnic Origin Event Funding Future Gender HIV HIV Infections HIV Seropositivity HIV diagnosis Health Health Promotion Health Status Health behavior Healthcare Home environment Housing Human immunodeficiency virus test Income Individual International International AIDS Intervention Interview Knowledge Laboratories Lead Life Life Experience Link Location Malaria Mediator of activation protein Medical Medical center Mental Depression Mental Health Modeling Morbidity - disease rate Newly Diagnosed Orphan Outcome Participant Patients Peer Review Persons Pharmaceutical Preparations Physicians Play Policies Population Study Predisposition Prevention Prevention education Protocols documentation Provider Psychosocial Factor Public Health Quality of life Recruitment Activity Regimen Reporting Research Research Personnel Resistance Resources Respondent Risk Risk Behaviors Risk Reduction Role Rural Sampling Self Efficacy Series Services Severities Sexual abuse Site Social support Socioeconomic Status Stigmata Stress Symptoms System Tanzania Testing Time Time Study Transportation Trauma Treatment Efficacy Treatment Protocols Treatment outcome Trust Tuberculosis Universities Viral Load result Virus Woman Work antiretroviral therapy base care seeking cohort coping cost cost effective demographics design diaries ethnic minority population fighting health care service utilization health related quality of life high risk high risk sexual behavior improved interest medication compliance mortality patient population physical abuse pill programs psychological distress psychosocial research study residence scale up service utilization social stigma symposium tertiary care treatment adherence urban area viral resistance

项目摘要

Two-thirds of the >38 million people with HIV/AIDS reside in Sub-Saharan Africa. Access to antiretroviral therapy (ART) in less wealthy nations is expanding quickly, creating an urgent need to understand those factors influencing adherence, a key determinant of ongoing efficacy of ART, so that the creation and spread of medication-resistant virus is limited. The proposed research team has identified suboptimal adherence among 29% of clinic attendees taking ART for > 6 months in Moshi Tanzania, while documenting lack of virologic suppression in 32% and antiretroviral drug resistance in 10%. We propose to follow 750 newly diagnosed HIV+ persons, 500 previously diagnosed HIV+ persons and 750 HIV-negative persons in over 3 years in this region. The newly diagnosed HIV+ and HIV- cohorts will be obtained through consecutive sampling in a Voluntary Counseling and Testing (VCT) site and the on-going HIV+ cohort will be similarly drawn from the Infectious Disease Clinic (IDC) in the tertiary care medical center 5 miles away. This research team has a track record of successful past and ongoing research at both the VCT and the IDC sites. Baseline data we will used to examine associations between psychosocial (including trauma, mental health symtomotology, coping strategies and life events), sociodemographic, and economic factors and health status, adherence to ART, and health promotion and high risk activities. Longitudinal analyses will examine causal relationships between changes in the independent and dependent variables. Results will lead to the creation of more effective prevention and care models for the area and other similar areas. Studying the population of ART naive patients in a resource poor setting provides a unique window of opportunity to gather data designed to increase our understanding of underlying variables associated with maladherence and risk behaviors. Psychosocial determinants are a unique strength of this proposal. The study will result in a minimum of 7 peer reviewed articles and disemination of findings at annual national (US and Tanzanian) and international AIDS, Public Health and Mental Health conferences, including the annual Tanzania national AIDS conference. A policy related report will be diseminated to national and international leaders.

3800万艾滋病毒/艾滋病的人中有三分之二居住在撒哈拉以南非洲。访问较少富裕国家的抗逆转录病毒疗法（ART）正在迅速扩大，迫切需要了解影响依从性的因素，这是艺术持续功效的关键决定因素，以便耐药病毒的创造和传播是有限的。拟议的研究团队有在29％的诊所参加者中确定了在Moshi服用ART> 6个月的诊所参与者的次优依从性坦桑尼亚，同时记录了32％的病毒学抑制和抗逆转录病毒抗药性的缺乏为10％。我们建议关注750个新诊断为HIV+患者，500名先前诊断为HIV+ 该地区3年以上的人和750名艾滋病毒阴性人。新诊断为HIV+和 HIV-同类将通过在自愿咨询和测试中连续抽样获得（VCT）部位和正在进行的HIV+队列将类似地从传染病诊所中汲取（IDC）在5英里外的第三纪念医疗中心。该研究团队的记录是在VCT和IDC网站上都成功的过去和正在进行的研究。我们将使用的基线数据检查社会心理（包括创伤，心理健康综合学，应对策略和生活事件），社会人口统计学以及经济因素和健康状况，遵守艺术，健康促进和高风险活动。纵向分析将检查独立变量和因变量的变化之间的因果关系。结果将带领为该地区和其他类似领域创建更有效的预防和护理模型。在资源不佳的情况下研究艺术的人群幼稚的患者提供了一个独特的窗口收集旨在提高我们对相关基本变量的理解的数据的机会不良和风险行为。社会心理决定因素是这种独特的优势提议。该研究将导致至少7个同行评审的文章和发现的否定在年度国家（美国和坦桑尼亚）和国际艾滋病上，公共卫生与心理健康会议，包括年度坦桑尼亚国家艾滋病会议。与政策有关的报告将是分配给国家和国际领导人。