Antiretviral therapy adherence in resource poor setting

描述（由申请人提供）：在撒哈拉以南非洲和其他资源有限的环境中，艾滋病毒抗逆转录病毒治疗已成为全球优先事项。虽然抗逆转录病毒药物价格的下降有望改善获得治疗的机会，但许多领导人对坚持治疗的情况不佳的毫无根据的担忧限制了人们对治疗的热情。目前没有公认的方法来衡量艾滋病毒抗逆转录病毒治疗的依从性，以确定依从性的特点或确定资源匮乏环境中依从性的预测因素。我们建议研究几种依从性测量策略的可接受性：在乌干达坎帕拉接受联合抗逆转录病毒治疗的HIV+患者中，电子药丸帽监测、未公布的家庭药丸计数和结构化患者自我报告。我们将进行定性访谈，这些技术在艾滋病毒+无家可归者和边缘居住的人在旧金山弗朗西斯科的可接受性。然后，我们将对这些措施的可行性和有效性进行定量研究（经定性访谈结果修改），并根据它们与艾滋病毒载量的对应关系进行评估。这将是在资源匮乏的环境中确定艾滋病毒抗逆转录病毒治疗的分布情况和坚持治疗的预测因素的第一步，也是必要的一步。

DESCRIPTION (provided by applicant): HIV antiretroviral treatment in sub-Saharan African and other resource-limited settings has become a global priority. While falling antiretroviral prices promise to improve access, unsubstantiated concerns regarding poor adherence by many leaders limits enthusiasm for treatment. There are currently no accepted approaches to measuring adherence to HIV antiretroviral therapy to characterize adherence or identify the predictors of adherence in resource poor settings. We propose to study the acceptability of several adherence measurement strategies: electronic pill cap monitoring, unannounced home pill count and structured patient self report in HIV+ people receiving combination antiretroviral therapy in Kampala, Uganda. We will conduct qualitative interviews regarding the acceptability of these techniques developed in HIV+ homeless and marginally housed people in San Francisco. We will then conduct a quantitative study of the feasibility and validity of these measures (modified by qualitative interviews findings) as assessed by their correspondence with HIV viral load. This will be a first and necessary step to identifying the distribution and predictors of adherence to HIV antiretroviral therapy in a resource poor setting.