DE LA TESIS:En los países desarrollados, la introducción del tratamiento antirretroviral de gran actividad (TARGA) ha revolucionado la perspectiva del paciente infectado por el virus de la Inmunodeficiencia Humana tipo 1(VIH), produciendo un aumento espectacular de la supervivencia y una reducción muy importante de las infecciones oportunistas y neoplasias asociadas al síndrome de inmunodeficiencia adquirida (SIDA). En este contexto, la infección crónica por el virus de la hepatitis C (VHC) ha tomado gran relevancia clínica situándose como una de las primeras causas de ingreso hospitalario y muerte en los pacientes infectados por el VIH.La coinfección de estos virus no es un proceso aislado. De los 40 millones estimados de pacientes infectados por el VIH-1 en el mundo, aproximadamente un tercio presenta una infección crónica por el VHC lo que supone unos 12 millones de pacientes coinfectados a nivel mundial. Aproximadamente el 30% de la población seropositiva está coinfectada por el VHC. Esta elevada tasa de prevalencia de coinfección se debe en gran medida a que ambos virus comparten similares vías de transmisión. Si nos centramos exclusivamente en los pacientes que han adquirido la infección por el VIH por vía parenteral, principalmente en pacientes adictos a drogas endovenosas o pacientes hemofílicos, este número se eleva aproximadamente a un 90% de los pacientes (6). Estudios epidemiológicos han demostrado que el 65% de los pacientes con adicción a drogas por vía parenteral presentan anticuerpos para el VHC a los 12 meses tras el inicio del consumo. Este dato permite calcular el tiempo que un paciente lleva infectado por el VHC. En los últimos años se ha detectado que los pacientes coinfectados por ambos virus tienen peor pronóstico que los monoinfectados por VHC. La progresión de la enfermedad hepática se encuentra acelerada, los pacientes presentan una mayor progresión a cirrosis, mayor incidencia de hepatocarcinoma, y menor supervivencia desde la primera descompensación respecto a los pacientes con monoinfectados por el VHC. Por tanto, la consideración del tratamiento de la VHC es una prioridad en el manejo y tratamiento de los pacientes coinfectados por el VIH y VHC.La presente tesis recoge un total de cinco artículos en los que se ha difundido la investigación asociada con la misma. El primero ("Noninvasive Diagnosis of Hepatic Fibrosis in HIV/HCV-Coinfected Patients". JAIDS 2007; 46:304-311) analiza los marcadores no invasivos de fibrosis hepática en pacientes infectados por el VIH y VHC. El segundo ("Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for treatment of HIV/HCV co-infected patients". AIDS. 2004; 18(13):27-36.) contiene un estudio clínico que compara dos estrategias de tratamiento de la hepatopatía por VHC con Peginterferon alfa-2b con ribavirina comparada con interferon alfa-2b con ribavirina en pacientes coinfectados por el VIH y el VHC. El tercer artículo ("Predictive Value of Early Virologic Response in HIV/Hepatitis C Virus-Coinfected Patients Treated With an Interferon-Based Regimen Plus Ribavirin". JAIDS 2007; 44:174-178.) estudia el valor predictivo de la RVP en pacientes coinfectados por VIH y VHC tratados con un régimen basado un interferon y ribavirina. Por su parte, el artículo número cuatro ("Randomized trial comparing pegylated interferon alpha-2b versus pegylated interferon alpha-2a, both plus ribavirin, to treat chronic hepatitis C in human immunodeficiency virus patients". Hepatology 2009; 49:22-31) realiza un estudio clínico randomizado que compara dos estrategias de tratamiento con interferón pegilado alfa 2a versus interferon pegilado alfa 2b junto con Ribavirina en ambos grupos en pacientes coinfectados por el VIH y VHC. Por último, el artículo cinco ("Pharmacokinetics of Fosamprenavir plus Ritonavir in HIV-1-infected Adult Subjects with Hepatic Impairment." Antimicrob. Agents Chemother. 2009; 53: 5185-96) realiza un estudio de farmacocinética de fase I con fosamprenavir y ritonavir en pacientes infectados por el VIH con disfunción hepática.

La presente investigación analiza la campaña “Tú PreVIHenes” desarrollada por el Ministerio de Salud (MINSA), cuyo objetivo era prevenir la presencia de las Infecciones de Transmisión Sexual (ITS) y el Virus de Inmunodeficiencia Humana (VIH) en las mujeres de nivel socioeconómico bajo a través del uso del condón con su pareja estable (hombre). Nuestro objeto de estudio son los spots que se trabajaron para televisión abierta: “Ella domina La Redonda” y “El Testimonial de la doctora Sasieta”; centrándonos en sus efectos en Lima Metropolitana. Para ello se realizó investigación bibliográfica, análisis semiológico y del discurso, así como entrevistas a expertos. Los objetivos planteados para la investigación son describir los procesos en la generación de insights, los mensajes empleados, su desarrollo y la efectividad del recurso empleado. Los datos antes de la campaña revelaron que este público no usaba el condón como método de protección. El spot de “La Redonda” apela al humor, y la analogía de la relación sexual con un partido de fútbol donde el hombre es el jugador, la mujer la referí que marca la falta (no uso del condón) y éste es el balón (la redonda); mientras que el de la “doctora Sasieta”, usa el testimonial y la advertencia (miedo) para incidir sobre el aumento de casos de VIH en este grupo. Tras la campaña, se observa que hubo poca recordación del mensaje, la conducta (no uso condón) continuó e incluso aumentó. Si bien la pauta de los spots no fue la ideal, tampoco fue pobre. Por ende, el problema estaba en los mensajes. Éstos desarrollan dos temas cruciales: La infidelidad y su aceptación tácita por parte de la mujer, y el uso del condón en parejas estables. Como conclusiones se puede decir que no es real que las mujeres acepten la infidelidad y menos que además sigan teniendo relaciones con la pareja infiel usando condón, el cual es dejado de lado por sus connotaciones negativas (incomodidad, dolor, disminución del placer, solo para relaciones fugaces, etc.). Por ende, los mensajes son considerados irreales, se pierde fuerza en el mensaje y su posibilidad de lograr el cambio de conducta esperado en el público objetivo. / Tesis

No description available.

Syfte: När städerna växer i allt snabbare takt behövs nya platser att bygga bostäder på. De kommuner som växer väljer allt oftare att bebygga platser som tidigare ratats på grund av bland annat buller. Från statens sida finns det krav på hur stor bullernivån får vara. Kraven har sitt ursprung i att över två miljoner svenskar utsätts för buller dagligen. Buller kan leda till hälsoproblematik, i form av sömnstörningar och hjärt- och kärlsjukdomar. För att minska hälsoproblemen görs bullerutredningar, där förslag hur bullernivåerna kan minskas ges. Syftet med arbetet är att ge läsaren kunskap i vilka faktorer som påverkar bullerutredningar och tillvägagångssättet vid valet av bullerreducerande åtgärder så att byggnation närmare trafikerad väg kan möjliggöras. Metod: De metoder som använts i arbetet är litteraturstudie, dokumentanalys och intervjuer. Den litteratur som samlats in består av vetenskapliga artiklar. Dokumenten består av bullerutredningar genomförda av olika företag på olika platser i Sverige. Utifrån bullerutredningarna har personer att intervjua valts. De personer som intervjuats har utfört några av de bullerutredningar som använts i dokumentanalysen. Resultat: För att besvara rapportens syfte ställdes tre frågeställningar upp. Den första frågeställningen behandlar bullerreducerande tekniker, vilka tekniker som används idag. I rapporten framkom det att det finns ett flertal sätt att reducera buller. I följande ordning rangordnas de som mest frekvent använda: tyst sida, bullerskärm, hastighetsminskning, avstånd mellan hus och väg, vegetation, flytt av väg och tyst asfalt. I rapportens andra frågeställning behandlas vilka faktorer som påverkar valet av bullerreducerande åtgärd. Från litteraturstudien framkom absorption, reflektion och reduktion som viktiga faktorer. I dokumentanalysen framkom omgivning, trafik och hastighet som viktiga faktorer. I intervjuerna framkom estetik och pris som viktiga vid val av reducerande åtgärd. I den tredje frågeställningen behandlas frågan om hur byggnation närmare väg kan möjliggöras. I resultatet framkommer det att alla lösningar som tidigare nämnts har förmåga att reducera buller, men hur effektiva de är och hur bra de reducerar buller varierar från fall till fall. Omgivning och trafikmängd har stor betydelse. Konsekvenser: Att utnyttja de tekniska lösningar som tidigare beskrivits ger en minskad bullernivå och således kan byggnation nära trafikerad väg möjliggöras. Att utföra en bullerutredning i ett tidigt skede medför att senare och dyrare ändringar kan undvikas, vilket gör att byggnationen kan ske snabbare. Rapporten föreslår att bullerproblematiken ska beaktas tidigt i projekt, detta för att skapa en lösning som alla i projektet kan acceptera. Begränsningar: Rapportens resultat är begränsat till ett mindre urval av bullerutredningar och intervjuer. Fler utredningar och intervjuer hade bidragit till ett större spektrum. Rapporten tar enbart hänsyn till buller utomhus och vilka möjligheter till bullerreduktion det finns. / Purpose: When cities grow at a faster rate, new places are needed to build housing.The municipalities that are growing tends to choose build sites that previously wererejected due to noise pollution. There are requirements from the state that the noise maynot exceed certain values. The requirements originate from the fact that over twomillion swedes are exposed to noise daily. Noise can lead to health problems, in theform of sleep disorders and cardiovascular disease. To reduce health problems noiseinvestigations are made, where suggestions are made in how noise levels can bereduced. The purpose of the work is to provide the reader with knowledge of whichfactors influence noise investigations and the approach to the choice of noise reductionmeasures so that construction can be made closer to trafficked roads. Method: The methods used are literature studies, document analysis and interviews.The literature gathered consists of scientific articles. The documents consist of noiseinvestigations conducted by different companies all over Sweden. Persons to interviewwere chosen from the conductors of the noise investigations documents. Findings: To answer the report's purpose, three questions were raised. The firstquestion deals with noise-reducing technologies and which technologies are used today.The report found that there are several ways to reduce noise. In the following order, themost frequently used are: silent facade, noise screen, speed reduction, distance betweenhouse and roads, vegetation, road moving and quiet asphalt. The second question of thereport addresses the factors that influence the choice of noise reduction measure. Fromthe literature study, absorption, reflection and reduction were found to be importantfactors. In the document analysis, surroundings, traffic and speed emerged as importantfactors. In the interviews, aesthetics and price emerged as important in the choice ofwhich reducing action should be taken. The third question deals with the question ofhow construction can be made closer to the road. In the result it appears that all of thesolutions mentioned earlier have the ability to reduce noise, but how effective they areand how well they reduce noise varies from case to case. Surroundings and trafficvolume are of great importance. Implications: Making use of the technical solutions previously described, results in areduced noise level and there for construction near road can be made possible.Executing a noise investigation at an early stage means that later and more expensivechanges can be avoided, which means that construction can take place sooner. Thereport suggests therefore that noise issues should be considered early in projects. It isalso important to get a solution that everyone can accept. Limitations: The report's results are limited to a smaller selection of noiseinvestigations and interviews. More investigations and interviews could hadcontributed to a larger spectrum. The report does only consider noise outdoors and whatopportunities for noise reduction there are.

Made available in DSpace on 2015-05-14T13:16:12Z (GMT). No. of bitstreams: 1 ArquivoTotalJosevania.pdf: 1804820 bytes, checksum: 2faca9f4e7bcb3bf70faae2640a56c8f (MD5) Previous issue date: 2011-11-23 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction and Objectives: What is the impact of the AIDS on the mental health and Quality of Life in people who are equal or superior the age of 50 years? This study had as General Objective to analyze the impact of AIDS on the mental health and Quality of Life on people who are equal or superior the age of 50 years for HIV (HIV+) seropositiv. Method: A number of 86 people who are equal or superior age of 50 years, HIV+ seropositiv were the participants of this study. It was composed two comparative groups: a) Group formed by 86 people HIV+ who are age below of the 50 years, in the age band of 40 49 years and b) Group formed by 86 people who are equal or superior age of the 50 years of the population in general, without the diagnosis of the HIV seropositiv. This study counted on the following instruments:1) Socio-demographic and clinical questionnaire; 2) Whoqol-HIV Brief scales; 3) Self-Reporting Questionnaire scales (SRQ-20); 4) Scale of Anxiety and Depression (HAD); and 5) Interview. For the analysis of the data originated by the socio-demographic questionnaire and the scales it was applied the descriptive and multivariate statistics analysis. The data of the interviews, the Thematic Categorical Analysis was carried out. Results: When compared with people of same age bands of the general population, the people in the maturity and in the old age with HIV/AIDS have greater damages in their mental health and in their quality of life, but they have not more damages than the people below of the 50 years HIV+. In the verification of the predictive variables, the factor Independence ( =0,414) was main the responsible for the explanation of the variance, followed by the Psychological factor (β=0, 29), and, of negative form, the Common Mental Disorders (β= -0, 20). The analysis of the participants stories counted with nine emerged categories: Infect, Diagnosis, Perception of the AIDS, AIDS in the old age, Confrontation, Support, Prejudice, Work and Perspectives. Conclusions: Living with the HIV/AIDS has its impact in some dimensions of the individual s life, contributing for the presence of Common Mental Disorders. The impact of the illness for the evaluation of the Quality of Life was verified, mainly, when compared with the people without the diagnosis of the illness, corroborating for the initial hypothesis of the study. Moreover, it has inter individual variations significant in terms of the impact of the illness for the people, despite with the same diagnostic. This variation of the impact suggests not only considering the changeable variables, such as the age, levels of CD4 or period of the disease (symptomatic or asymptomatic), a time that such variation might be related to the subjective nature of the individual s reply to a intricate interaction of inherent factors of living with the illness, as verified in the participants narratives. / Introdução e Objetivo: Qual o impacto da AIDS para a saúde mental e a Qualidade de Vida em pessoas com idade igual ou superior a 50 anos? Este estudo teve por Objetivo Geral analisar o impacto da AIDS na saúde mental e Qualidade de Vida de pessoas com idade igual ou superior a 50 anos soropositivas para o HIV (HIV+). Método: Participaram 86 pessoas HIV+ com idade igual ou superior a 50 anos. Foram constituídos, ainda, dois grupos comparativos: a) Grupo formado por 86 pessoas HIV+ com idade abaixo de 50 anos, na faixa-etária de 40 a 49 anos e b) Grupo formado por 86 pessoas com idade igual ou superior a 50 anos da população em geral, sem o diagnóstico de soropositividade ao HIV. Foram utilizados os seguintes instrumentos: 1) Questionário sociodemográfico e clínico; 2) Escala Whoqol-HIV Bref; 3) Escala Self-Reporting Questionnaire (SRQ-20); 4) Escala de Ansiedade e Depressão (HAD); e 5) Entrevista. Para a análise dos dados do questionário sociodemográfico e das escalas foram realizadas análises de estatística descritiva e multivariada. Já para os dados das entrevistas, utilizou-se a Análise Categorial Temática. Resultados: Quando comparado com pessoas de mesma faixa etária da população geral, as pessoas na maturidade e velhice com HIV/AIDS têm maiores prejuízos na saúde mental e na qualidade de vida, mas não mais que as pessoas abaixo de 50 anos HIV+. Na verificação das variáveis preditivas, O fator Independência (b=0,414) foi o principal responsável pela explicação da variância, seguido do fator Psicológico (β=0,29), e, de forma negativa, os Transtornos Mentais Comuns (β= -0,20). A partir da análise dos relatos dos participantes, emergiram nove categorias: Contágio, Diagnóstico, Percepção da AIDS, AIDS na velhice, Enfrentamento, Suporte, Preconceito, Trabalho e Perspectivas. Conclusão: A convivência com o HIV/AIDS tem impacto em várias dimensões da vida de um indivíduo, contribuindo para a presença de Transtornos Mentais Comuns. O impacto da doença para a avaliação de Qualidade de Vida foi verificado, principalmente, quando comparado com as pessoas sem o diagnóstico da doença, corroborando a hipótese inicial do estudo. Além disso, há variações interindividual significativa em termos do impacto da doença para as pessoas, ainda que com o mesmo diagnóstico. Esta variação do impacto sugere considerar não só variáveis ​​mensuráveis, tais como a idade, níveis de CD4 ou estágio da doença (sintomático ou assintomático), uma vez que tal variação pode estar relacionada à natureza subjetiva da resposta do indivíduo a uma complexa interação de fatores inerentes à convivência com a doença, conforme verificado nos relatos dos participantes.

Sweden introduced a development assistance policy in 1952 and thirteen years later Sida, Swedish International Development Cooperation Agency started, in 1965. But in 1995, five separate development assistance authorities came together and established the new Sida as it is today. Sida is Sweden’s representative in the development assistance policy field and they work through projects that have to be presented through a Country Strategy Process (CSP). The aim of this paper is to point out Sida’s perspective on the conducted development assistance policy and what guide lines that are followed. The main purpose of the development assistance policy is to create better conditions for the distressed countries. Russia is a country that receives big sums of money from Sida, but the support given is about to be phased out and in 2010 it will be completely terminated. The cooperation with Russia will go through a transition to normal cross-border cooperation as a neighboring country. We have chosen to characterize Sida’s work with Russia and other countries through two perspectives on poverty; an orthodox perspective, which is a more ideologically conservative approach, and an alternative perspective, which is a more liberal approach.

This paper outlines the current situation of Internet usage and attitudes towards the Internet among ordinary people in Arusha, Tanzania, and examines the views of ordinary citizens on the effects of the arrival of Internet and the possible digital divide. Using qualitative interviews with equal groups of ordinary Internet users and ordinary non- Internet users in Arusha, the authors found varying levels of awareness about Internet services and facilities and their availability. There was also a widespread concern about immoral western influences communicated by the Internet and how it may affect the domestic culture. It was clearly shown that Internet usage and the possibility to utilize the information found is dependent on education levels and the economic situation of the users, two closely related factors. To get additional views on the subject interviews were also carried out with representatives for Radio and TV stations as well as newspapers located in Arusha, institutions for higher education in the ICT field, Internet providers, and Arusha Municipal Council. To examine the actual Internet usage we extracted random samples of visited websites in several of the Internet cafés, which most of the Arushans use to access the Internet. It was found that government action is necessary that the in order to bridge the digital divide, but as a result of systematic censorship of media government efforts meet a profound distrust among people, neither does the government consider this to be any of their responsibilities.

Program utvärderingar utgör till stor del grunden till det formella lärandet inom Sida (Swedish International Development Cooperation Agency). Utvärderingars syfte är att bistå med kunskap och Utvärderingar ska garantera att insatser är baserade på god förståelse om verkligheten i mottagarländerna. Genom att gynna organisatoriskt lärande förmodas utvärderingar bidra till biståndets effektivitet (Stefan Molund, 2004).   Teorier om den lärande organisationen hävdar att organisationers fall beror på medlemmars tendens att förenkla och misstolka verkligheten. Medvetet eller omedvetet leder detta till att organisationens vision försvagas, medlemmars engagemang försvagas och den verklighet man sökt att förändra förblir den samma (Peter M. Senge, 1994).   Genom att bistå sektorer som hälsa, utbildning och demokrati mm. har det svenska biståndet präglats av en objektiv eller positivistisk syn på verkligheten i utvecklingsländer. Insatser inom hälsa leder onekligen till effektivitet i fattigdomsbekämpningen.   Min uppsats visar hur Sidas strävan efter objektivitet löper risken att försvaga organisationens vision. I de fattigaste och mest socialt komplexa utvecklingsländerna finns inte förutsättningarna[1] för objektiv utvärdering, och resultaten av en utvärdering blir ofta öppna för olika tolkningar. Trots att utvärderingarna skildrar en sann bild av verkligheten så leder detta till frustration hos handläggare. Resultatet blir att utvärderingar görs av program som handläggarna redan har god kunskap om. Mitt resultat visar att denna trend successivt försvagar Sidas vision då insatser ämnade åt att öka effektiviteten i biståndet allokeras från de ”fattigaste länderna” till länder som kommit längre i utvecklingsprocessen. [1] De “fattigaste” utvecklingsländerna saknar de institutioner för datainsamling som krävs för objektiv utvärdering. Att skapa förutsättningarna för den kostnadseffektiva objektiva utvärderingen i utvecklingsländer är ett utvecklingsmål som vilket annat som ingår i den övergripande fattigdomsbekämpningen. / Presentation har ägt rum

Submitted by Ana Lúcia Torres (bfmhuap@gmail.com) on 2017-11-01T14:40:48Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação Rafael Agostini.pdf: 883692 bytes, checksum: 15d5d4feff64006d386e8cf3f786bb6e (MD5) / Approved for entry into archive by Ana Lúcia Torres (bfmhuap@gmail.com) on 2017-11-01T14:40:58Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação Rafael Agostini.pdf: 883692 bytes, checksum: 15d5d4feff64006d386e8cf3f786bb6e (MD5) / Made available in DSpace on 2017-11-01T14:40:58Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertação Rafael Agostini.pdf: 883692 bytes, checksum: 15d5d4feff64006d386e8cf3f786bb6e (MD5) Previous issue date: 2016-04 / Fundação Oswaldo Cruz. Comitê Comunitário Assessor do Instituto de Pesquisa Clínica Evandro Chagas / Ao longo das quase quatro décadas que convivemos com o Vírus da Imunodeficiência Adquirida sua administração clínica sofreu mudanças consideráveis. O prolongamento temporal impõe aos sujeitos VIH+ pre) posicionamentos no agenciamento da vida e da enfermidade a partir da perspectiva de uma doença de longa duração. Necessidade de adequação dos hábitos e comportamentos, frequente interação com serviços e profissionais da saúde e uso contínuo de medicamentos – além da convivência com os impactos sociais, subjetivos e mesmo físicos da enfermidade – são algumas das questões. O objetivo desta pesquisa foi compreender e os sentidos e significados atribuídos à convivência com a doença e suas consequentes implicações. Foram realizadas seis entrevistas abertas em profundidade com jovens VIH+ de camadas populares, de ambos os sexos, de transmissão materno-infantil entre 18 e 22 anos. A partir de uma questão disparadora, espraiamos para dimensões da vida dos jovens referentes à revelação do diagnóstico, relações afetivas e representações do vírus, do tratamento e da doença. O material produzido foi analisado a partir de uma perspectiva socioantropológica que se ancorou na análise temática. Os resultados indicam que os antirretrovirais têm centralidade nos discursos e são vistos como responsáveis pela manutenção da saúde. A normalidade como eixo estruturante do diagnóstico contrastou com o fato de que a maioria dos entrevistados preferia manter segredo sobre sua sorologia. O ativismo aparece como forma de encontrar lugar para a sorologia no curso da vida e como estratégia acionada para lidar com o cotidiano após o diagnóstico. No campo da sexualidade, a possibilidade de compartilhar a gestão de cuidados com os parceiros, o medo de ser rejeitado e a enorme preocupação com a possibilidade de infectar alguém formam um caudaloso misto de experiências. Enfim, os dados apontam que as fronteiras entre os sentidos e experiências do “agudo” e “crônico” não são um Aqueronte a ser transposto, mas dois lados que se tocam / Over the nearly four decades that lived with the Human Immunodeficiency Virus their clinical management has undergone considerable changes. The temporal extension requires the subject HIV + (re) positioning the assemblage of life and illness from the perspective of a long-term illness. Adequacy need of habits and behaviors, frequent interaction with services and health professionals and continued use of drugs - in addition to familiarity with the social, subjective and even physical infirmity - are some of the issues. The aim of this study was to understand and the meanings attributed to living with the disease and its consequent implications. They were held six open interviews in depth with young mother to child transmission from 18 to 22 years. From a starter question, espraiamos to dimensions of life of young people regarding the disclosure, emotional relationships and representations of the virus, treatment and disease. The material produced was analyzed from a socio-anthropological perspective that is anchored in the thematic analysis. The results indicate that antiretroviral drugs are central in the discourse and are seen as responsible for the maintenance of health. Normality as structure diagnosis contrasted with the fact that most respondents preferred to keep secret about their HIV status. Activism appears as a way to find a place for serology in the course of life and as a strategy driven to deal with everyday life after diagnosis. In the field of sexuality, the possibility of sharing the care management with partners, fear of being rejected and the enormous concern about the possibility of infecting someone form a mixed mighty experiences. Finally, the data show that the boundaries between the senses and experiences of the "acute" and "chronic" are not a Acheron to be overcome, but two sides meet

Partant de problématiques statistiques rencontrées dans l'étude du traitement antirétroviral des adultes infectés par le virus de l'immunodéficience humaine (VIH) en Afrique subsaharienne, cette thèse cherche, d'une part, à favoriser la vulgarisation d'outils méthodologiques relativement récents auprès d'un public d'utilisateurs moins avertis et, d'autre part, à participer au développement de nouveaux outils. Le premier chapitre présente différentes méthodes de modélisation des données longitudinales dont des méthodes d'analyse de l'évolution d'un critère au cours du temps (les modèles linéaires mixtes généralisés et les modèles d'équations d'estimation généralisées) ou de la survenue d'un évènement au cours du temps (le modèle semi-paramétrique de Cox et ses extensions à la prise en compte des covariables dépendantes du temps et de la censure informative). Le deuxième chapitre s'intéresse aux tests de non-infériorité et propose deux développements de la procédure classique de ces tests pour les cas où la marge de non-infériorité est relative. Enfin, le troisième chapitre aborde la question des données manquantes et propose une extension de la méthode d'imputation multiple par les distributions conditionnelles univariées qui consiste à prendre en compte des effets non-linéaires des covariables dans les modèles d'imputation par des fonctions B-splines. Ces méthodes sont illustrées par des études sur le VIH au Cameroun et au Sénégal. / On the basis of statistical challenges encountered in study of antiretroviral treatment of adults infected with human immunodeficiency virus (HIV) in sub-Saharan Africa, this thesis aims to promote the dissemination of relatively recent methodological tools of less aware audience of users on one hand and to participate to development of new tools on the other hand. The first chapter presents various methods for modeling longitudinal data of which analysis methods for changing of a criterion over time (the generalized linear mixed models and models of generalized estimating equations) or the occurrence of an event over time (the semi-parametric Cox model and its extensions to take into account time-dependent covariates and informative censoring). The second chapter focuses on non-inferiority test and provides two developments of the classical procedure of these tests in cases where the non-inferiority margin is relative. The third chapter addresses the question of missing data and proposes an extension of the multiple imputation method based on fully conditional specification, to take into account nonlinear effects of covariates in the imputation models using B-splines functions. These methods are illustrated by studies on HIV in Cameroon and Senegal.