Coping With HIV/AIDS in Tanzania

超过3800万艾滋病毒/艾滋病患者中有三分之二居住在撒哈拉以南非洲。获得 抗逆转录病毒疗法（ART）在不太富裕的国家正在迅速扩大，迫切需要 了解影响依从性的因素，这是ART持续疗效的关键决定因素， 抗药性病毒的产生和传播受到限制。拟议的研究小组已 在莫希，29%的接受抗逆转录病毒治疗超过6个月的诊所就诊者中，发现依从性不佳 坦桑尼亚，虽然记录了32%缺乏病毒学抑制和抗逆转录病毒药物耐药性 百分之十我们建议跟踪750名新诊断的HIV+患者，500名以前诊断的HIV+患者， 在该地区，3年多来有750人和750名艾滋病毒阴性者。新诊断的艾滋病毒+和 艾滋病毒-队列将通过自愿咨询和检测中的连续采样获得 (VCT)研究中心和正在进行的HIV+队列将同样从传染病诊所抽取 (IDC)在五英里外的三级医疗中心这个研究小组有一个跟踪记录， 在自愿咨询和检测中心和国际数据中心进行的成功的过去和正在进行的研究。我们将使用的基线数据 检查心理社会（包括创伤，心理健康符号学， 应对策略和生活事件）、社会人口和经济因素以及健康状况， 坚持抗逆转录病毒疗法，促进健康和高风险活动。纵向分析将检查 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造更有效的预防和护理模式。 在资源匮乏的环境中研究ART初治患者人群提供了一个独特的窗口， 收集数据的机会，旨在增加我们对相关潜在变量的理解 不守规矩和冒险行为心理社会决定因素是一个独特的力量， 提议本研究将产生至少7篇同行评审文章和发现结果 在年度国家（美国和坦桑尼亚）和国际艾滋病，公共卫生和心理健康 会议，包括坦桑尼亚全国艾滋病年会。一份政策报告将 向国家和国际领导人发出警告。

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.