Coping With HIV/AIDS in Tanzania

坦桑尼亚应对艾滋病毒/艾滋病

• 批准号: 7285771
• 负责人: KATHRYN WHETTEN
• 金额: $ 64.91万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-06 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7285771
• 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; Appendix; Appointment; Area; Bed Occupancy; Belief; CD4 Lymphocyte Count; Caregivers; Caring; Case Manager; Characteristics; Child Care; Clinic; Clinical Data; Cohort Studies; Communicable Diseases; Communities; Comorbidity; Complex; Counseling; Count; Country; Cross-Sectional Studies; Daily; Data; Data Analyses; Data Collection; Deltastab; Diagnosis; Disease; Disease Progression; Economic Factors; Economics; Education; Emergency Situation; Enabling Factors; Enrollment; Ensure; Ethnic Origin; Event; Facilities and Administrative Costs; Family; Frequencies; Fright; Funding; Future; Gender; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; Health Promotion; Health Services Research; Health Status; Health behavior; Healthcare; Home environment; Housing; Human immunodeficiency virus test; Income; Individual; Infection; 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; Numbers; Orphan; Outcome; Participant; Patients; Peer Review; Persons; Pharmaceutical Preparations; Physicians; Play; Policies; Population; Population Study; Predisposing Factor; Predisposition; Prevention; Prevention education; Principal Investigator; Protocols documentation; Provider; Psyche structure; Psychosocial Factor; Public Health; Quality of life; Rate; Recruitment Activity; Reporting; Research; Research Personnel; Resistance; Resources; Respondent; Risk; Risk Behaviors; Risk Reduction; Role; Rural; Sampling; Self Efficacy; Series; Services; Severities; Site; Social Characteristics; Social support; Socioeconomic Status; Stigmata; Stress; Symptoms; System; Tanzania; Testing; Time; Time Study; Transportation; Trauma; Treatment Efficacy; Treatment Protocols; Treatment outcome; Trust; Tuberculosis; Universities; Use Effectiveness; Violence; Viral; Viral Load result; Virus; Visit; Woman; Work; antiretroviral therapy; base; care seeking; cohort; coping; cost; day; demographics; design; diaries; ethnic minority population; fighting; health care service utilization; health related quality of life; high risk sexual behavior; improved; interest; medication compliance; mortality; physical abuse; pill; prescription document; prescription procedure; programs; psychological distress; psychosocial; research study; residence; scale up; service utilization; social stigma; symposium; tertiary care; urban area

DESCRIPTION (provided by applicant): 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 symptomatology, 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 dissemination 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 disseminated to national and international leaders.

描述（由申请人提供）：全球3800万艾滋病患者中有三分之二居住在撒哈拉以南非洲。在较不富裕的国家，获得抗逆转录病毒治疗的机会正在迅速扩大，因此迫切需要了解影响依从性的因素，这是抗逆转录病毒治疗持续有效性的关键决定因素，以便限制耐药病毒的产生和传播。拟议的研究小组已经确定，在坦桑尼亚Moshi，接受抗逆转录病毒治疗6个月的临床参与者中，有29%的人依从性不佳，同时记录了32%的人缺乏病毒学抑制，10%的人缺乏抗逆转录病毒药物耐药性。我们建议在该地区对750名新诊断的HIV阳性患者、500名以前诊断的HIV阳性患者和750名HIV阴性患者进行3年以上的随访。新诊断的HIV+和HIV-队列将通过自愿咨询和测试（VCT）站点的连续抽样获得，而正在进行的HIV+队列将同样从5英里外的三级保健医疗中心的传染病诊所（IDC）中抽取。该研究团队在VCT和IDC网站上都有成功的过去和正在进行的研究记录。我们将使用基线数据来检查社会心理（包括创伤、精神健康症状、应对策略和生活事件）、社会人口统计学和经济因素与健康状况、抗逆转录病毒治疗依从性、健康促进和高风险活动之间的关系。纵向分析将检验自变量和因变量变化之间的因果关系。结果将导致为该地区和其他类似地区创建更有效的预防和护理模式。在资源贫乏的环境中研究抗逆转录病毒治疗的初次患者群体，为收集旨在增进我们对与不良依从性和危险行为相关的潜在变量的理解的数据提供了一个独特的机会。社会心理决定因素是这一建议的独特优势。这项研究将产生至少7篇同行评议文章，并在年度国家（美国和坦桑尼亚）和国际艾滋病、公共卫生和精神卫生会议，包括年度坦桑尼亚国家艾滋病会议上传播研究结果。将向国家和国际领导人散发一份与政策有关的报告。