A fundamental worldwide public health concern is the growth of HIV incidence rates and the fact that two thirds of this global pandemic is located in sub-Saharan Africa. A concerted effort to control the diseases prevalence within integrated comprehensive care frameworks for underserved populations remains a critical international priority. Integration of services to halt the spread of HIV is of significant international public health relevance and will require greater collaboration at local, national, and international policy levels. Comprehensive care is a simple concept that is profoundly complex to implement in countries that have previously established vertical tuberculosis treatment regimes and sexual and reproductive health programs. In resource poor countries such as Mozambique, there is a great deal more research and learning necessary to assure the efficacious delivery of anti-retroviral therapy as part of improved medical adherence follow-up programs. Evidence from the literature revealed that many HIV-infected persons are not responding to medication regimens due to a lack of medication adherence that includes loss-to-follow-up cases and a lack of access to health care services. For this applied research project, a pilot program was designed for the University of Pittsburgh, School of Medicines Treatment and Care Initiative in Beira, Mozambique. This programs goal is to increase adherence to HIV treatment regimens within a comprehensive care model that recognizes the impact of social determinants of health. The proposed intervention has five intended outcomes: first, to develop a five-year plan with stakeholder input; second, to improve clinician, medical student and patient communication regarding the barriers and solutions to HIV medical adherence; third, to develop a baseline for loss to follow-up cases through a health care worker outreach effort; fourth, to integrate medication treatment regimens for co-infected HIV/TB patients with Central Hospital of Beira; and fifth, to conduct an outcome evaluation assessing project impact on HIV/AIDS medical adherence. Mozambican cultural factors that may influence medical adherence behavior also were examined.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-07212009-160401 |
| Date | 29 September 2009 |
| Creators | White, Susan Marie |
| Contributors | Martha A. Terry, Wesley Rohrer, Jeremy Martinson |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-07212009-160401/ |
| Rights | restricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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