London Sch of Hygiene and Trop Medicine

尽管非洲在提供抗逆转录病毒疗法(ART)方面取得了进展，但大多数艾滋病毒感染者仍然没有得到诊断，许多人在疾病晚期到艾滋病毒诊所注册，或者没有定期参加后续预约。这可能导致延迟启动，或对抗逆转录病毒疗法的坚持不良，进而增加死亡率和出现抗药性艾滋病毒株。这项研究将增强我们对艾滋病毒服务覆盖面自抗逆转录病毒药物提供以来是如何演变的理解。它将评估哪些艾滋病毒检测和治疗模式鼓励及早获得艾滋病毒护理，并调查如何促进艾滋病毒诊所的长期就诊。特别是，这项研究将探索社会支持、家庭环境和伙伴关系因素与获得艾滋病毒服务之间的关系。这项研究将在坦桑尼亚农村进行，自1994年以来，在那里对3万人进行了血清学、人口学和行为监测，并与艾滋病毒诊所数据建立了匿名链接。这一综合系统提供了一个独特的机会，可以监测艾滋病毒服务复盖面中的社会人口不平等现象，并深入了解影响服务使用的方案和社会因素。研究结果将产生切实可行的政策建议，以鼓励高水平的早期、持续和公平地获得艾滋病毒服务。

Despite progress in delivering antiretroviral therapy (ART) in Africa, most HIV-infected persons remain undiagnosed, and many enroll in HIV clinics at an advanced stage of disease or do not regularly attend follow-up appointments. This can result in delayed initiation, or poor adherence to ART, which in turn increases mortality and the emergence of drug-resistant HIV strains.This research will enhance our understanding of how coverage with HIV services has evolved since ART became available. It will evaluate which HIV testing and treatment models encourage early access to HIV care, and investigate how long-life attendance at HIV clinics can be promoted. In particular, the research will explore the relationship between social support, family circumstances and partnership factors and access to HIV services. The research will be undertaken in rural Tanzania, where serological, demographic and behavioural surveillance has been conducted among 30,000 people since 1994, with anonymous links to HIV clinic data. This integrated system provides a unique opportunity to monitor socio-demographic inequities in HIV service coverage and gain insights into the programmatic and social factors that influence service use. The findings will lead to practical policy recommendations to encourage high levels of early, sustained and equitable access to HIV services.