Projecting the Epidemiologic and Economic Impact of HIV Prevention Efforts in the Context of Other Sexually Transmitted Infections

预测其他性传播感染背景下艾滋病毒预防工作的流行病学和经济影响

• 批准号: 10308082
• 负责人: Parastu Kasaie
• 金额: $ 11.81万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-12-10 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10308082
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adherence; Age; Area; Award; Baltimore; Behavioral; Centers for Disease Control and Prevention (U.S.); Chlamydia; Cities; Collaborations; Computational Science; Cost Analysis; Data; Decision Modeling; Diagnosis; Drug usage; Economic Models; Epidemic; Epidemiology; Faculty; Funding; Goals; Gonorrhea; HIV; HIV Infections; Health; Healthcare; Incidence; Individual; Infection; Intervention; Investigation; Knowledge; Light; Mathematical Model Simulation; Mentors; Mentorship; Methodology; Methods; Modeling; Nature; Newly Diagnosed; Outcome; Pathway Analysis; Pattern; Policies; Population; Prevention; Prevention strategy; Property; Race; Reporting; Research; Resources; Risk; Role; Running; STI prevention; Scientist; Series; Services; Sexual Partners; Sexual Transmission; Sexually Transmitted Diseases; Solid; Stream; Structure; Syphilis; Target Populations; Techniques; Testing; Time; Training; Translations; United States; Variant; antiretroviral therapy; base; behavioral disinhibition; career development; co-infection; cost; cost effectiveness; cost estimate; density; economic evaluation; economic impact; epidemiologic data; epidemiological model; evidence base; experience; fighting; health care economics; high risk; high risk population; implementation intervention; improved; incremental cost-effectiveness; innovation; interdisciplinary approach; meetings; member; men who have sex with men; models and simulation; multidisciplinary; novel; pre-exposure prophylaxis; preventive intervention; programs; sexual HIV transmission; sexual role; sexually active; skills; social; success; surveillance data; surveillance study; synergism; transmission process; trend; uptake

PROJECT SUMMARY/ABSTRACT Despite improvements in efficacy and coverage of antiretroviral therapy, the incidence of HIV in the United States (US) has failed to decline substantially in the last decade, while earlier declines in the incidence of other sexually transmitted infections (STIs) have recently reversed. As prevention dollars run short, it is important to identify strategies for efficiently investing resources to lower the burden of these interconnected epidemics. This mentored research scientist career development (K01) proposal would enable an accomplished junior candidate with expertise in agent-based simulation modeling to expand her skillset while describing network factors underpinning HIV transmission among men who have sex with men (MSM), modeling the epidemiological impact of combined prevention interventions for HIV and other STIs, and quantifying the cost- effectiveness of those interventions – thus filling critical knowledge gaps in our current understanding of HIV/STI transmission and prevention in the US. The candidate's proposed research involves a rigorous, model-based investigation into the HIV/STI co- epidemic among MSM in Baltimore City – a representative setting for which strong epidemiological and surveillance data exists. To understand the co-transmission dynamics of HIV and other STIs, the candidate will develop a series of contact networks using ten years of surveillance and contact investigation data available through Baltimore City Health Department (BCHD) and will quantify changes in the structure of this network over the last decade (Aim 1). To study and compare the impact of different prevention interventions on HIV/STI spread, the candidate will develop detailed models of STI co-transmission, including HIV, syphilis, gonorrhea and chlamydia. These models will be used to project the epidemiologic impact of targeting Pre-Exposure Prophylaxis (PrEP) to MSM diagnosed with other STIs and/or their sexual partners (Aim 2), and to assess the cost-effectiveness of strategies for PrEP implementation (Aim 3) at different levels of program coverage and individual uptake and adherence. The candidate for this award is a junior faculty member with a background in computational sciences who has more recently developed experience in HIV/AIDS research. During this award period, the candidate will be mentored by a multidisciplinary team of experts with complimentary skills in areas related to her research aims and training goals. Her K01 training goals are (1) to acquire expertise in analysis of social and sexual networks, (2) to develop a solid understanding of HIV/STI epidemiology and coinfection, (3) to gain experience in methods for economic evaluation, and (4) to improve her skills in mentorship, management, and collaboration with diverse stakeholders in order to achieve a successful transition to independence. Her long- term goal is to become an independent scientist developing and applying innovative analytical techniques to improve policies to help end the co-epidemics of HIV and other STIs among MSM in the US, and more broadly.

项目总结/摘要 尽管抗逆转录病毒疗法的疗效和覆盖面有所改善， 美国在过去十年中未能大幅下降，而其他国家的发病率在早些时候有所下降。 性传播感染最近有所逆转。由于预防资金短缺， 确定有效投资资源的战略，以减轻这些相互关联的流行病造成的负担。 这个指导研究科学家职业发展（K 01）的建议将使一个有成就的初级 具有基于代理的仿真建模专业知识的候选人，以扩展其技能，同时描述网络 男男性行为者（MSM）中艾滋病毒传播的基础因素， 艾滋病毒和其他性传播感染综合预防干预措施的流行病学影响，并量化成本， 这些干预措施的有效性-从而填补了我们目前对 艾滋病毒/性病在美国的传播和预防。 候选人提出的研究涉及对艾滋病毒/性传播感染共同的严格的，基于模型的调查， 在巴尔的摩市的男男性接触者中流行病-一个具有代表性的环境， 有监测数据。为了了解艾滋病毒和其他性传播感染的共同传播动态，候选人将 利用十年的监测和接触调查数据建立一系列接触网络 通过巴尔的摩市卫生局（BCHD），并将量化该网络结构的变化 在过去的十年里（目标1）。研究和比较不同预防干预措施对艾滋病毒/性传播感染的影响 传播，候选人将制定详细的模型，性病共传播，包括艾滋病毒，梅毒，淋病 和衣原体。这些模型将用于预测针对暴露前的流行病学影响 对诊断患有其他性传播感染的男男性行为者和/或其性伴侣进行预防性治疗（PrEP）（目标2），并评估 在不同的计划覆盖水平上实施PrEP战略（目标3）的成本效益， 个人吸收和坚持。 该奖项的候选人是一名具有计算科学背景的初级教员， 最近在艾滋病毒/艾滋病研究方面积累了经验。在此期间，候选人将 由多学科专家团队指导，在与她的研究目标相关的领域具有互补技能 和训练目标。她的K 01培训目标是（1）获得社会和性分析方面的专业知识 网络，（2）深入了解艾滋病毒/性传播感染流行病学和合并感染，（3）获得经验 在经济评估方法，和（4）提高她的技能，指导，管理， 与各利益攸关方合作，以实现向独立的成功过渡。她的长- 长期目标是成为一名独立的科学家，开发和应用创新的分析技术， 改善政策，以帮助结束艾滋病毒和其他性传播感染在美国和更广泛的男男性行为者中的共同流行。