Making Better Decisions: Policy Modeling for AIDS and Drug Abuse

说明（由申请人提供）：艾滋病毒流行的严重性以及预防和治疗资源的有限性迫使规划人员和提供者在采取何种干预措施预防和治疗艾滋病毒和药物滥用方面作出艰难的选择。我们项目的目标是评估现有和潜在的艾滋病毒和药物滥用干预措施，以提供关于有效性、公共卫生影响和效率的关键信息。该项目旨在通过建立数学和经济模型，促进艾滋病毒和药物滥用预防和治疗领域的合理规划和政策制定。为实现这一目标，我们提出了以下具体目标：评估项目支出与健康结果之间关系的生产函数，如预防项目的危险行为减少和治疗项目的服务提供。开发基于模型的方法，将艾滋病毒相关干预措施的行为影响转化为流行病学上有意义的结果衡量指标，例如挽救生命的年数。3. 确定如何最好地估计艾滋病毒和药物滥用干预措施的健康结果、经济结果和成本效益。4. 评估旨在预防和治疗艾滋病毒和药物滥用的具体干预措施的有效性和成本效益。5. 通过审查预防和治疗干预措施组合的有效性和成本效益，为社会资源的分配提供信息。这项工作包括分析国家和国际艾滋病毒预防和治疗战略，并评估如何平衡艾滋病毒预防和治疗干预措施，以实现最大的健康效益。6. 研究艾滋病毒和药物滥用领域的政策建模与公共卫生决策之间的关系，特别是探讨如何使分析对决策者最有用。拟议的研究将推动艾滋病毒规划和政策建模方面的最新进展，批判性地评估有前途的干预措施，并有助于为将稀缺资源分配给艾滋病毒和药物滥用预防和治疗干预措施组合提供科学基础。

DESCRIPTION (provided by applicant): The severity of the HIV epidemic and limits on prevention and treatment resources have forced planners and providers to make difficult choices about which interventions to implement to prevent and treat HIV and substance abuse. The goal of our project is to evaluate existing and potential HIV and substance abuse interventions to provide critical information on effectiveness, public-health impact, and efficiency. This project aims to promote reasoned planning and policy making in the realm of HIV and substance abuse prevention and treatment via the development of mathematical and economic models. To achieve this goal, we have the following specific aims: 1. To estimate production functions that characterize the relationship between program expenditures and health outcomes, such as reductions in risky behaviors for prevention programs and delivery of services for treatment programs 2. To develop model-based methods of translating the behavioral impact of HIV-related interventions into epidemiologically meaningful outcome measures, such as years of life saved. 3. To determine how best to estimate health outcomes, economic outcomes, and cost effectiveness of HIV and substance abuse interventions. 4. To assess the effectiveness and cost-effectiveness of specific interventions aimed at preventing and treating HIV and substance abuse. 5. To inform the allocation of societal resources by examining the effectiveness and cost effectiveness of portfolios of prevention and treatment interventions. This work includes analyzing national and international HIV prevention and treatment strategies, and assessing how to balance HIV prevention and treatment interventions to achieve the greatest health benefit. 6. To examine the relationship between policy modeling and public health decision making in the areas of HIV and substance abuse - in particular, to explore how to make analyses most useful to policy makers. The proposed research will advance the state of the art in HIV planning and policy modeling, critically evaluate promising interventions, and help provide the scientific foundation for allocation of scarce resources to portfolios of HIV and substance abuse prevention and treatment interventions.