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Diagnosing and preventing HIV infection in adolescents and young adults in the US: clinical impact and cost-effectiveness

诊断和预防美国青少年和年轻人的艾滋病毒感染：临床影响和成本效益

基本信息

批准号：
10450185
负责人：
Anne Neilan
金额：
$ 17.28万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-07 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10450185
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address Adherence Adolescent Medicine Adolescent and Young Adult Adult Affect Age Area Behavior Behavioral Sciences Caring Centers for Disease Control and Prevention (U.S.)Chronic Disease Clinical Clinical Investigator Clinical Research Clinical Trials Communicable Diseases Complex Computer Models Computer Simulation Continuity of Patient Care Cost Effectiveness Analysis Data Analyses Derivation procedure Development Diagnosis Disease model Effectiveness Epidemic Epidemiology Fellowship Foundations Future General Hospitals Goals HIV HIV Infections HIV diagnosis HIV-infected adolescents Health Health Care Costs Health Policy Health behavior Individual Infection Intervention K-Series Research Career Programs Massachusetts Medicine Mentors Mentorship Methodology Methods Modality Modeling NIH Office of AIDS Research National Institute of Child Health and Human Development Observational Study Outcome Pathway interactions Pattern Patterns of Care Pediatrics Performance Pharmaceutical Preparations Physicians Policies Population Positioning Attribute Prevalence Prevention Prevention approach Public Health Publishing Research Research Personnel Research Priority Research Support Resources Risk Scientist Service delivery model Services Structure Study models Techniques Time Toxic effect Training United States National Institutes of Health Viral Vulnerable Populations Work Youth aged antiretroviral therapy base care seeking career career development clinical decision-making cost effectiveness design disorder prevention economic outcome effective intervention experience health care delivery health economics high risk improved improved outcome innovation investigator training medication compliance model development models and simulation multidisciplinary novel novel strategies pre-exposure prophylaxis prevent prevention service research and development screening screening services transmission process treatment adherence vulnerable adolescent young men who have sex with men

项目摘要

Project Summary/Abstract New HIV infections among youth ages 13-24 comprise 22% of all new HIV infections in the US. More than 60,000 adolescents and young adults (AYA) are already living with HIV in the US, and new infections contribute substantially to HIV transmission. The HIV epidemic among US AYA demands new approaches to HIV diagnosis and prevention, with consideration of the challenges of health care delivery and research among AYA living with and at risk of acquiring HIV. Computer simulation health-policy models can add substantial value to clinical trials and observational studies by projecting outcomes beyond the time horizon of clinical studies. This is particularly important for AYA, in whom the effects of HIV infection and treatment may not manifest for many years. This mentored clinical scientist research career development award will allow the recipient, an infectious diseases physician at Massachusetts General Hospital, to develop a research career using modeling methods and cost-effectiveness analysis to evaluate current critical questions in HIV prevention and screening in US AYA. Reducing incident HIV infections, improving HIV screening, optimizing HIV pre-exposure prophylaxis services, and assessing HIV pre-exposure prophylaxis effectiveness are high- priority areas for the NIH Office of AIDS Research (2018 Goals) and NICHD (2017 New Research Priorities). Collaborating with national studies of AYA affected by HIV, this project will develop a new, comprehensive health policy model of HIV disease prevention, diagnosis and treatment in AYA. The model will reflect age- and developmentally-specific AYA patterns of care-seeking behaviors, including engagment in care and adherence to medications. The model will be used to evaluate the short- and long-term clinical outcomes and healthcare costs associated with the screening and prevention of HIV in US AYA, focusing on a key sub-population, young men who have sex with men.This work will build a foundation for future analyses of the delivery of HIV pre-exposure prophylaxis and other emerging screening, treatment and prevention modalities. This mentored research will be accompanied by relevant training in model development, derivation of trial-based model inputs, and performance of policy-relevant analyses. This research and career development training provide the recipient with a pathway to an independent career as a clinical investigator, focused on using modeling methodology to optimize care for adolescents and young adults affected by HIV.

项目总结/摘要在美国，13-24岁的年轻人新感染艾滋病毒占所有新感染艾滋病毒的22%。超过在美国，有6万名青少年和年轻人（AYA）已经感染了艾滋病毒，对艾滋病毒的传播有很大的影响。美国AYA中的艾滋病毒流行需要新的方法，艾滋病毒的诊断和预防，同时考虑到艾滋病毒感染者在提供保健和研究方面的挑战 AYA携带艾滋病毒并有感染艾滋病毒的风险。计算机模拟健康政策模型可以增加大量的临床试验和观察性研究的价值，通过预测临床试验时间范围以外的结果，问题研究这对AYA来说尤其重要，因为艾滋病毒感染和治疗的影响可能不会多年来，这个指导临床科学家研究职业发展奖将允许收件人是马萨诸塞州总医院的传染病医生，以发展研究事业使用建模方法和成本效益分析来评估艾滋病毒当前的关键问题美国AYA的预防和筛查。减少艾滋病毒感染事件，改善艾滋病毒筛查，优化艾滋病毒暴露前预防服务和评估艾滋病毒暴露前预防的有效性很高- NIH艾滋病研究办公室（2018年目标）和NICHD（2017年新研究优先事项）的优先领域。该项目将与艾滋病毒感染者的国家研究合作，艾滋病预防、诊断和治疗卫生政策模式。该模型将反映年龄-和特定于发展的AYA寻求护理行为模式，包括对护理和依从性的依赖药物治疗该模型将用于评估短期和长期临床结局和医疗保健在美国AYA与艾滋病毒筛查和预防相关的费用，重点关注关键亚群，这项工作将为今后分析艾滋病毒的传播奠定基础暴露前预防和其他新兴的筛查、治疗和预防方式。这一指导研究将伴随着模型开发、基于试验的模型推导的相关培训政策相关分析的投入和绩效。这项研究和职业发展培训提供接受者有一条通往独立职业生涯的道路，作为一名临床研究者，专注于使用建模为受艾滋病毒影响的青少年提供最佳护理的方法。