Calibration and Simulation of the Botswana Combination Prevention Project

博茨瓦纳组合预防项目的校准和模拟

• 批准号: 9318571
• 负责人: George R Seage
• 金额: $ 49.28万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9318571
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; African; Award; Behavioral; Botswana; Calibration; Centers for Disease Control and Prevention (U.S.); Communities; Counseling; Country; Data; Diffusion; Epidemic; Epidemiology; Future; Generations; HIV; HIV prevention trial; HIV vaccine; Human immunodeficiency virus test; Incidence; Individual; Intervention; Life Expectancy; Long-Term Effects; Male Circumcision; Methods; Modeling; Policies; Policy Analysis; Population; Prevalence; Prevention; Prevention program; Prevention strategy; Preventive Intervention; Process; Property; Public Health Schools; Research Personnel; Role; Southern Africa; Structure; Testing; TimeLine; Treatment Efficacy; U-Series Cooperative Agreements; Uncertainty; Vertical Disease Transmission; antiretroviral therapy; base; comparative efficacy; cost effectiveness; high risk sexual behavior; improved; innovation; interest; migration; network models; public health relevance; randomized trial; simulation; standard of care; success; transmission process; treatment program; treatment trial; uptake

 DESCRIPTION (provided by applicant): There has been increased interest in the implementation of combination HIV prevention and treatment trials in order to better understand their effects on the HIV epidemic. The Harvard School of Public Health has been awarded a CDC Cooperative Agreement to evaluate the Botswana Combination Prevention Project (BCPP), a matched paired community-randomized trial of an enhanced combination prevention package (CP) that includes expanded coverage of HIV counseling and testing, prevention of mother to child transmission, male circumcision, and treatment as prevention in Botswana. We aim to simulate the BCPP using an agent-based stochastic model, the HIV Calibrated Dynamic Model (HIV-CDM) in order to inform the use of combination prevention in Botswana and southern Africa. The HIV-CDM simulates transmission of HIV from infected individuals to uninfected individuals. This expansive, detailed and innovative model will reflect the best available data from prevention studies, Botswana specific HIV epidemiology and treatment. The three specific aims are: Aim 1: To calibrate the HIV-CDM to Botswana population parameters, including HIV incidence and prevalence, using Bayesian melding type methods. To perform simple sensitivity analyses to understand the effects of historical antiretroviral therapy (ART) rollout and high risk sexual behavior on the epidemic dynamics between 2002 and 2012. Aim 2: To simulate the BCPP trial to estimate the overall impact of the CP and the contributory role of each component on the 36 month HIV cumulative incidence among 16-64 year old residents in Botswana, and the expected future timeline and the particular combinations of HIV prevention programs that may result in an AIDS-free generation in Botswana. Aim 3: To understand the epidemiologic and policy impact of explicitly incorporating sexual network structure and uncertainty in parameters on the results of an agent-based model. Expanding the HIV-CDM to Botswana will allow the BCPP investigators to conduct policy and sensitivity analyses to fully evaluate the impact of the CP in Botswana.

 描述（由申请人提供）：为了更好地了解其对艾滋病毒流行的影响，对实施艾滋病毒预防和治疗联合试验的兴趣越来越大。哈佛公共卫生学院获得了CDC合作协议，以评估博茨瓦纳联合预防项目（BCPP），这是一项配对的社区随机试验，旨在加强联合预防包（CP），包括扩大艾滋病毒咨询和检测的覆盖范围，预防母婴传播，男性包皮环切术，以及博茨瓦纳的预防治疗。我们的目标是模拟BCPP使用基于代理的随机模型，艾滋病病毒校准动态模型（HIV-CDM），以通知在博茨瓦纳和南部非洲的组合预防的使用。HIV-CDM模拟HIV从感染个体向未感染个体的传播。这一广泛、详细和创新的模式将反映预防研究、博茨瓦纳具体的艾滋病毒流行病学和治疗方面的现有最佳数据。这三个具体目标是：目标1：使用贝叶斯融合型方法，根据博茨瓦纳人口参数（包括艾滋病毒发病率和流行率）校准HIV-CDM。进行简单的敏感性分析，以了解2002年至2012年期间历史抗逆转录病毒治疗（ART）的推出和高风险性行为对流行动态的影响。目标二：模拟BCPP试验，以估计CP的总体影响和每个组成部分对博茨瓦纳16-64岁居民36个月HIV累积发病率的贡献作用，以及预期的未来时间轴和可能导致博茨瓦纳无艾滋病一代的HIV预防计划的特定组合。目标三：了解明确纳入性网络结构和参数的不确定性对基于代理的模型的结果的流行病学和政策的影响。将艾滋病毒清洁发展机制扩大到博茨瓦纳将使博茨瓦纳预防艾滋病方案的调查人员能够进行政策和敏感性分析，以充分评估博茨瓦纳预防艾滋病方案的影响。