Yale University

Models of health care delivery for people living with HIV: Influences on treatment adherence and HIV risk behaviors and the role of psychosocial factors

Funder: Fogarty International Center
Project period: 09/01/2012 - 06/30/2013
Grant Type: Training

Abstract Text:

The current HIV epidemic in Russia represents a serious public health concern. However, associations between structure of health care delivery and psychosocial, behavioral and other characteristics of people living with HIV/AIDS have not been sufficiently studied. The purpose of the research is to study characteristics (focused on patients’ outcomes) of the different models of care delivery in St. Petersburg for HIV-infected patients. The current study includes medical records review to describe patients of the St.Petersburg AIDS Center and district infection disease departments. Then we will conduct a cross-sectional hospital-based study divided into two nested phases. The first one will include face-to-face quantitative surveys with patients of the St.Petersburg AIDS Center and district infection disease departments. This phase also includes chart review to obtain such measures as CD4 count, adherence (by pharmacy refill and medical records), service utilization, comorbid conditions for each respondent. During next phase we will perform face-to-face clinical interviews with those on HAART about substance abuse and mental illness. The aim of the survey is to describe demographic, social, psychological, and socioeconomic characteristics of patients utilizing different models of HIV care and to assess patient outcomes. Specifically, will perform the stratified analysis of all characteristic of patients (social, psychological, medical, demographic, and socioeconomic) with regard to different models of care delivery to evaluate the influence of particular model of care delivery system to such outcomes as adherence to HAART, risky behavior and satisfaction among patients of St. Petersburg AIDS Center and district infection disease departments. In other words, we are trying to compare patient outcomes between models, controlling for patient characteristics. The long-term goal of this project is to benefit people living with HIV/AIDS in the future by looking at HIV care delivery in St. Petersburg.

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