title: Lessons from Tanzania on the integration of HIV and tuberculosis treatments into methadone assisted treatment.
abstract: To successfully address HIV and TB in the world, we must address the healthcare needs of key populations, such as drug users, and we must do this urgently. Currently in Tanzania, as in many countries, the care for these medical disorders is separated into disease specific clinical environments. Our consortium began working to integrate HIV and TB clinical services into the methadone program in Dar es Salaam, Tanzania. We present the key lessons learned in this process of integration and the importance of integrating HIV/TB into the methadone program, which serves as a critical anchor for adherence to clinical services. Integrated healthcare for people who use drugs is clearly a long-term goal and different health systems will progress upon this continuum at different rates. What is clear is that every health system that interacts with drug users must aspire to achieve some level of integrated healthcare if the incidence rates of HIV and TB are to decline.
authors.affiliation: Yale University School of Medicine, New Haven, CT, United States; Pangaea Global AIDS Foundation, United States; Yale University School of Public Health, United States. Electronic address: rdouglasbruce@mac.com.
authors.forename: R Douglas
authors.initials: RD
authors.lastname: Bruce
authors.affiliation: Pangaea Global AIDS Foundation, United States; University of Washington, Department of Global Health, Seattle, WA.
authors.forename: Barrot
authors.initials: B
authors.lastname: Lambdin
authors.affiliation: Pangaea Global AIDS Foundation, United States.
authors.forename: Olivia
authors.initials: O
authors.lastname: Chang
authors.affiliation: Muhimbili National Hospital, Tanzania; Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Frank
authors.initials: F
authors.lastname: Masao
authors.affiliation: Muhimbili National Hospital, Tanzania; Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Jessie
authors.initials: J
authors.lastname: Mbwambo
authors.affiliation: Muhimbili National Hospital, Tanzania.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Mteza
authors.affiliation: Muhimbili National Hospital, Tanzania; Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Cassian
authors.initials: C
authors.lastname: Nyandindi
authors.affiliation: University of California, Berkley, School of Public Health, United States.
authors.forename: Sophia
authors.initials: S
authors.lastname: Zamudio-Haas
authors.affiliation: Muhimbili National Hospital, Tanzania; Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Deus
authors.initials: D
authors.lastname: Buma
authors.affiliation: Pangaea Global AIDS Foundation, United States.
authors.forename: Megan S
authors.initials: MS
authors.lastname: Dunbar
authors.affiliation: Muhimbili University of Health and Allied Sciences, Tanzania.
authors.forename: Gad
authors.initials: G
authors.lastname: Kilonzo
mesh_terms: D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration*; D008691:Methadone / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000150:complications / Q000188:drug therapy*; D016730:Program Development; D013636:Tanzania; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy*
chemical_list: D008691:Methadone
keywords: HIV; Integrated care; Methadone; Tuberculosis