Evaluating large-scale HIV prevention interventions: study design for an integrated mathematical modelling approach
Evaluating large-scale HIV prevention interventions: study design for an integrated mathematical modelling approach
复制标题
DOI：
10.1136/sti.2007.027516
复制
发表时间：
2007-12-01
影响因子：
3.6
通讯作者：
Alary, M.
中科院分区：
文献类型：
--
作者：
Boily, M-C;Lowndes, C. M.;Alary, M.
背景资料：有一个迫切需要评估艾滋病毒预防干预措施，从而提高我们的理解，什么工作，在什么情况下，什么是成本efficient.Objectives：描述一个综合的数学评价框架，旨在评估人口一级的影响，大规模的艾滋病毒干预措施和应用的背景下，阿瓦汉，印度艾滋病倡议，在印度南部。Avahan倡议是一项大规模的艾滋病毒预防干预措施，由比尔及梅琳达·盖茨基金会资助，针对受艾滋病毒/艾滋病流行影响最严重的六个州选定地区的高危人群（马哈拉施特拉邦、卡纳塔克邦、泰米尔纳德邦、安得拉邦、那加兰和曼尼普尔）和沿着国道。Avahan监测和评价的一个重要组成部分依赖于一个综合数学框架，该框架结合了来自干预地区不同亚群的经验性生物和行为数据，与使用量身定制的传输动态模型嵌入在Bayesian framework.Results：概述了Avahan倡议和目标的监测和评估的干预措施。选择这种评价设计与其他可能的设计相比，提出的理由，并描述了评价框架的不同组成部分，其优点和挑战进行了讨论，并举例说明examines.Conclusions：这是第一次这样的方法已被应用在如此大的规模。从CHARME项目中吸取的经验教训可以帮助设计今后对其他环境中大规模干预措施的评价，而评价结果将与方案和公共卫生相关。
Background: There is an urgent need to evaluate HIV prevention interventions, thereby improving our understanding of what works, under what circumstances and what is cost effective.Objectives: To describe an integrated mathematical evaluation framework designed to assess the population-level impact of large-scale HIV interventions and applied in the context of Avahan, the Indian AIDS Initiative, in southern India. The Avahan Initiative is a large-scale HIV prevention intervention, funded by the Bill & Melinda Gates Foundation, which targets high-risk groups in selected districts of the six states most affected by the HIV/AIDS epidemic (Maharashtra, Karnataka, Tamil Nadu, Andhra Pradesh, Nagaland and Manipur) and along the national highways.Methods: One important component of the monitoring and evaluation of Avahan relies on an integrated mathematical framework that combines empirical biological and behavioural data from different subpopulations in the intervention areas, with the use of tailor-made transmission dynamics models embedded within a Bayesian framework.Results: An overview of the Avahan Initiative and the objectives of the monitoring and evaluation of the intervention is given. The rationale for choosing this evaluation design compared with other possible designs is presented, and the different components of the evaluation framework are described and its advantages and challenges are discussed, with illustrated examples.Conclusions: This is the first time such an approach has been applied on such a large scale. Lessons learnt from the CHARME project could help in the design of future evaluations of large-scale interventions in other settings, whereas the results of the evaluation will be of programmatic and public health relevance.