Using agent-based modeling to estimate the effectiveness of the Miami Getting to Zero HIV campaign

项目摘要/摘要 基于代理人的建模为流行病学家提供了一种先进的工具来估计严重的流行病学 在众多不同人群中取得的成果。拟议的研究将建立在一个成熟的模型基础上。 平台，艾滋病毒校准动态模型(艾滋病毒-清洁发展机制)，以构建迈阿密艾滋病毒流行的模型， 这是该国艾滋病毒新感染率最高的国家之一。 为了应对迈阿密日益严重的艾滋病毒流行，当地政策制定者、临床医生和研究人员组成了 这是一个旨在消灭迈阿密大都市地区所有新的艾滋病毒感染的“迈向零”特别工作组。 这项运动建立在联合预防的原则基础上，该原则要求同时使用许多 循证预防战略，如治疗即预防、暴露前预防(PrEP)和 经常/有针对性地进行艾滋病毒检测。目前还不清楚这项运动将对艾滋病毒事件产生什么影响 迈阿密的传染病。这项建议寻求使用基于代理的建模来估计 2017年通过的实现零增长运动中概述的联合预防计划。与.一起 估计具体的流行病结果(例如，艾滋病毒发病率、艾滋病毒流行率、消除疫情的时间)，这 方法还可以评估每个组成部分对项目成功的相对贡献。是这样的 估计数对于最大限度地实现运动目标以及协助执行 类似的艾滋病毒消除计划。 这一建议将：(1)扩展HIV-CDM模型，模拟人群的人口统计和HIV危险行为 迈阿密城市人口多样化；(2)评估迈向零的成功和局限性 利用艾滋病毒-清洁发展机制模式开展宣传活动；以及(3)在以下分组内进行初级和二级分析 迈阿密人口更好地了解当前的研究差距，以及前两个目标中确定的那些差距。每个人 研究计划的组成部分将得到支持，并与旨在 为候选人提供必要的专业发展和指导，以执行研究 目标，并开始独立的研究生涯。 从这项工作中获得的结果可能会直接影响迈阿密归零运动的评估 并为美国和全球未来所有消除艾滋病毒的运动提供信息。此外，培训计划将 提供卓越的方法和实践经验，导致独立和有影响力的科学 职业生涯。支持这项工作的将是一个由学术和社区领导人组成的指导小组， 流行病学和建模方法。这种指导将建立在方法论和实质性的基础上 我在领导许多关于流行病建模和艾滋病毒流行病学的研究时展示了自己的经验。

Project Summary/Abstract Agent-based modeling has provided epidemiologists with an advanced tool to estimate critical epidemiologic outcomes among large, diverse populations. The proposed research will build on a well-established model platform, the HIV-Calibrated Dynamic Model (HIV-CDM), to construct a model of the HIV epidemic in Miami, which experiences among the highest rates of new HIV infection in the country. In response to the growing HIV epidemic in Miami, local policymakers, clinicians, and researchers have formed a “Getting to Zero” Task Force that seeks to eliminate all new HIV infections in the Miami metropolitan area. The campaign is founded on the principle of combination prevention, which enlists the concurrent use of many evidence-based prevention strategies, such as treatment as prevention, pre-exposure prophylaxis (PrEP), and frequent/targeted HIV testing. Presently it is unknown what effect this campaign will have on incident HIV infections in Miami. This proposal seeks to use agent-based modeling to estimate the long-term impact of the combination prevention program outlined in the Getting to Zero campaign adopted in 2017. Along with estimating specific epidemic outcomes (e.g., HIV incidence, HIV prevalence, time to epidemic elimination), this approach may also assess the relative contribution of each component to the success of the program. Such estimates will be crucial in maximizing the goals of the campaign, as well as assist with the implementation of similar HIV elimination programs. This proposal will: (1) expand the HIV-CDM model, to simulate the demographics and HIV risk behavior of the diverse metropolitan Miami population; (2) estimate the success and limitations of the Getting to Zero campaign using the HIV-CDM model; and (3) perform primary and secondary analyses within subgroups of the Miami population to better understand current research gaps, and those identified in the first two aims. Each component of the research plan will be supported and aligned with specific training components designed to provide the candidate with the necessary professional development and mentorship to execute the research aims, and begin an independent research career. The results obtained from this work may directly impact the assessment of the Miami Getting to Zero campaign and inform all future HIV elimination campaigns in the U.S. and globally. Additionally, the training program will provide exceptional methodological and practical experience leading to an independent and influential scientific career. Supporting this work will be a mentorship team of academic and community leaders in HIV elimination, epidemiology and modeling methodology. This mentorship will build on the methodological and substantive experience I have demonstrated while leading numerous studies on epidemic modeling and HIV epidemiology.