Optimizing HIV prevention portfolios targeting people who inject drugs using dynamic economic modeling

项目概要/摘要 该提案旨在通过制定一项 108个国家注射吸毒者艾滋病毒预防流行病经济模型（PWID） 使用新获得的全球系统性综述数据。PWID仍然是艾滋病毒的主要风险群体 在东欧和中亚，艾滋病毒新感染者大多数是通过传播途径感染的。 此外，艾滋病感染者是中东和北非以及南部非洲艾滋病流行的重要驱动因素。 和东南亚。即使在艾滋病毒普遍流行的国家， 感染负担和难以获得预防干预措施，造成的差距限制了 实现联合国艾滋病规划署到2030年将艾滋病发病率降低90%的目标。各国政府缺乏关于 最有效和最具成本效益的干预组合，以预防艾滋病毒感染者。新提供的和 我们团队正在进行的全球系统性综述数据为解决这一问题提供了重要的新数据 问题我们的总体目标是利用动态的方法优化艾滋病毒预防政策制定， 经济建模由多个大型数据源提供信息。该提案采用了 通过以下具体目标开发、验证和传播：1）开发流行病 评估艾滋病毒预防组合对每个有艾滋病毒的国家的艾滋病毒感染者的影响的模型 PWID（全球108个国家）的患病率数据，基于来自多个大型系统的数据 评论. 2)估计最佳一揽子干预措施的预算影响和成本效益 实现艾滋病规划署在每个国家的艾滋病感染者中的艾滋病毒发病率目标。3)外部验证 在艾滋病毒阳性的艾滋病感染者人数最多的9个主要国家建立了一种模式。4)开发一个用户友好和 以网络为基础的多平台门户网站，用于发布流行病经济模型和相关数据。 我们的流行病建模师，系统性审查专家和药物政策研究人员团队是独一无二的 准备利用这些全面的新数据，为如何应对艾滋病毒流行病提供重要见解 在全球范围内的PWID。我们的工作将产生重大影响，指导决策者在知情的情况下， 关于在这一弱势群体中预防艾滋病毒的决定。我们的建议涉及 艾滋病研究的高度优先领域是"降低艾滋病毒/艾滋病发病率"。

Project Summary/Abstract This proposal aims to optimize country and regional HIV prevention strategies by developing an epidemic economic model of HIV prevention among people who inject drugs (PWID) for 108 countries worldwide using newly available global systematic review data. PWID remain a key risk group for HIV transmission, comprising the majority of new HIV infections in Eastern Europe and Central Asia. Additionally, PWID are important drivers of HIV epidemics in the Middle East and North Africa, and South and South East Asia. Even in countries with generalized HIV epidemics, PWID frequently have an elevated burden of infection and poor access to prevention interventions, creating disparities which limit the ability to achieve the UNAIDS target to reduce HIV incidence by 90% by 2030. Governments lack guidance on the most effective and cost-effective intervention portfolio to prevent HIV among PWID. Newly available and on-going global systematic review data compiled by our team provides important new data to address this question. Our overarching aim is to optimize HIV prevention policymaking for PWID using dynamic economic modeling informed by multiple large data sources. This proposal incorporates model development, validation, and dissemination, through the following specific aims: 1) Develop an epidemic model to estimate the impact of HIV prevention portfolios among PWID for every country with available HIV prevalence data among PWID (108 countries worldwide), based on data from multiple large systematic reviews. 2) Estimate the budgetary impact and cost-effectiveness of the optimal package of interventions for achieving the UNAIDS HIV incidence target among PWID in each country. 3) Externally validate the model in 9 key countries with the highest numbers of HIV-positive PWID. 4) Develop a user-friendly and web-based multi-platform portal for dissemination of the epidemic economic model and associated data. Our team of epidemic modelers, systematic review experts, and drug policy researchers are uniquely poised to utilize these comprehensive new data to provide critical insight into how to tackle HIV epidemics among PWID globally. Our work will have significant impact, guiding policymakers to make informed decisions regarding preventing HIV among this vulnerable group. Our proposal addresses the Office of AIDS Research high priority area of “reducing the incidence of HIV/AIDS.”