Evaluating the integrated methadone and anti-retroviral therapy strategy in Tanzania using the RE-AIM framework

摘要: There are an estimated 50,000 people who inject drugs in Tanzania, with HIV prevalence this population of 42%. The Integrated Methadone and Anti-Retroviral Therapy (IMAT) strategy was developed to integrate services into opioid treatment program (OTP) sub-Saharan Africa increase anti-retroviral therapy (ART) initiation rates. In paper, we evaluate the IMAT using implementation science framework inform future care integration efforts region. centralized OTP clinic Dar Es Salaam, Tanzania: diagnosis, ART initiation, monitoring follow up. A mixed-methods, concurrent design, used for evaluation: quantitative programmatic data semi-structured interviews providers clients addressed 4 out 5 components RE-AIM framework: reach, effectiveness, adoption, implementation. Results showed high reach: 98% HIV-positive received services; effectiveness: 90-day rate doubled, from 41% pre-IMAT 87% post-IMAT (p < 0.001); proportion eligible on increased 71% 0.001). adoption protocol fidelity. Qualitative results informed barriers facilitators components. conclusion, successfully integrated rates initiation. represents effective model improve delivery clients.