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White, Susan Marie (2009) HIV/AIDS MEDICAL ADHERENCE IN BEIRA, MOZAMBIQUE. Master's Thesis, University of Pittsburgh. (Unpublished)

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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 disease's 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 Medicine's Treatment and Care Initiative in Beira, Mozambique. This program's 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.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
White, Susan
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairTerry, Martha Amaterry@pitt.eduMATERRY
Committee MemberMartinson,
Committee MemberRohrer, Wesleywmrun@pitt.eduWMRUN
Date: 29 September 2009
Date Type: Completion
Defense Date: 9 July 2009
Approval Date: 29 September 2009
Submission Date: 21 July 2009
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Behavioral and Community Health Sciences
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: antiretroviral therapy; clinical follow-up; continuity of care; HIV medication adherence; Mozambique; sub-Saharan Africa; tuberculosis control
Other ID:, etd-07212009-160401
Date Deposited: 10 Nov 2011 19:52
Last Modified: 15 Nov 2016 13:46


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