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

项目摘要/摘要 这项建议旨在通过制定一项 108个国家注射吸毒者HIV预防的流行经济学模型 全球范围内使用新获得的全球系统审查数据。PWID仍然是HIV的关键风险群体 传播，构成东欧和中亚新增艾滋病毒感染的大多数。 此外，PWID是中东、北非和南非艾滋病毒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，PWID经常有较高的 感染负担和难以获得预防干预措施，造成差距，限制了 实现联合国艾滋病规划署到2030年将艾滋病毒发病率降低90%的目标。各国政府在这方面缺乏指导 最有效和最具成本效益的干预措施组合，以预防PWID中的艾滋病毒。新推出的和 我们团队正在汇编的全球系统评审数据为解决这一问题提供了重要的新数据 问题。我们的首要目标是使用Dynamic优化PWID的艾滋病毒预防决策 由多个大型数据源提供信息的经济建模。这项建议纳入了模式 通过以下具体目标发展、确认和传播：1)发展流行病 评估艾滋病预防组合对每个艾滋病毒可用国家的影响的模型 PWID(全球108个国家/地区)的流行率数据，基于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 为实现艾滋病规划署在各国残疾人中的艾滋病毒发病率目标。3)外部验证 在艾滋病毒阳性PWID人数最多的9个关键国家建立了这一模式。4)开发一个用户友好的和 基于网络的多平台门户网站，用于传播疫情经济模型和相关数据。 我们的流行病模型师、系统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提供关键的见解 在全球PWID中。我们的工作将产生重大影响，指导政策制定者 关于在这一弱势群体中预防艾滋病毒的决定。我们的提案针对的是 艾滋病研究的优先领域是“减少艾滋病毒/艾滋病的发病率”。

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.”