Coping With HIV/AIDS in Tanzania

在3800万艾滋病毒/艾滋病患者中，三分之二生活在撒哈拉以南非洲。进入 抗逆转录病毒疗法(ART)在不太富裕的国家迅速扩大，迫切需要 了解影响依从性的那些因素，这是抗逆转录病毒疗法持续有效性的关键决定因素，以便 耐药病毒的产生和传播是有限的。拟议的研究小组已经 在莫什市接受抗逆转录病毒治疗6个月的29%的门诊患者中，发现依从性不佳 坦桑尼亚，而32%的人缺乏病毒学抑制和抗逆转录病毒药物耐药性 在10%内。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3年多的时间里，该区域有3500名艾滋病毒感染者和750名艾滋病毒阴性者。新诊断的HIV+和 将通过自愿咨询和检测中的连续抽样获得艾滋病毒队列 (VCT)站点和正在进行的HIV+队列将同样从传染病诊所提取 (IDC)在5英里外的三级保健医疗中心。这个研究团队的记录是 在VCT和IDC站点成功地进行了过去和正在进行的研究。我们将使用的基准数据 研究心理社会(包括创伤、精神健康症状学、 应对策略和生活事件)、社会人口、经济因素和健康状况， 坚持抗逆转录病毒治疗，促进健康和高风险活动。纵向分析将检验 自变量和因变量变化之间的因果关系。结果将领先 为该地区和其他类似地区建立更有效的预防和护理模式。 在资源匮乏的情况下研究未接受抗逆转录病毒治疗的患者群体提供了一个独特的窗口 有机会收集旨在增加我们对相关潜在变量的了解的数据 不守规矩和危险行为。心理社会决定因素是这一点的独特力量 求婚。这项研究将导致至少7篇同行评议的文章和调查结果的消失 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上 会议，包括一年一度的坦桑尼亚全国艾滋病会议。与政策相关的报告将是 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.