Targeting Acute HIV

描述(申请人提供)：拟议的项目名为“针对急性艾滋病毒”，涉及评估、优化和扩展北卡罗来纳州的有效传播计划(STAT)的筛查和跟踪。正如目前在全州范围内实施的那样，STAT计划涵盖北卡罗来纳州所有由公共资金资助的常规艾滋病毒咨询和检测(每年120,000人)。STAT通过在中央州立公共卫生实验室使用新的样本池和艾滋病毒RNA检测方法来检测这一人群中非常早期的急性艾滋病毒感染。通过这些方法确定的急性艾滋病毒病例引发了由专业疾病干预专家组成的特别小组立即启动确证测试、网络通知和合作伙伴筛查。STAT计划预期收集关于急性病例及其接触者的广泛数据，从而为在大范围地理区域内发生的艾滋病毒活跃传播提供一个独特的窗口。本申请中描述的拟议研究利用了这些数据，以解决我们目前对艾滋病毒传播及其预防的理解存在的重大差距。我们组建了一支经验丰富的调查团队，目的是：1.评估大规模、基于初级保健的急性艾滋病毒筛查和合作伙伴通知计划的影响和表现；2.表征北卡罗来纳州常规检测人群中出现的急性艾滋病毒感染情况，并制定针对基于初级保健的急性艾滋病毒筛查的诊断策略；3.描述在北卡罗来纳州社区中有意或无意传播艾滋病毒的艾滋病毒阳性个体群体；以及4.进行详细的成本效益建模，以优化以艾滋病毒为中心的急性艾滋病毒预防工作。

DESCRIPTION (provided by applicant): The proposed project, entitled "Targeting Acute HIV," involves the evaluation, optimization and extension of North Carolina's Screening and Tracing of Active Transmission Program (STAT). As presently implemented statewide, the STAT Program encompasses all publicly funded routine HIV counseling and testing in NC (n= 120,000 annually). STAT provides for detection of very early acute HIV infections in this population by using novel specimen pooling and HIV RNA detection methods in a central State Laboratory of Public Health. Cases of acute HIV identified by these methods trigger initiation of immediate confirmatory testing, network notification and partner screening by a special team of professional Disease Intervention Specialists. The STAT program is prospectively collecting extensive data on acute cases and their contacts, thereby providing a unique window on active HIV transmission taking place over a large geographic area. The proposed research described in this application capitalizes on these data in order to address significant gaps in our current understanding of HIV transmission and its prevention. We have assembled an experienced team of investigators in order to: 1. Evaluate the impact and performance of a large scale, primary care-based acute HIV screening and partner notification program; 2. Characterize acute HIV infection as it presents in NC's routine testing population, and develop diagnostic strategies for targeting primary care-based acute HIV screening; 3. Describe a population of HIV positive individuals who are either knowingly or unknowingly transmitting HIV in NC communities; and 4. Perform detailed cost effectiveness modeling in order to optimize acute HIV-centered efforts at HIV prevention.