Cost-Effectiveness of Preventing Acute-Phase HIV Transmission

预防艾滋病毒急性期传播的成本效益

• 批准号: 7544905
• 负责人: Steven D. Pinkerton
• 金额: $ 31.25万
• 依托单位: MEDICAL COLLEGE OF WISCONSIN
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-01-25 至 2010-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7544905
• 关键词: AIDS prevention; Acute; Address; Anti-Retroviral Agents; Antibodies; Behavioral; Costs and Benefits; Counseling; Coupled; Development; Economics; Epidemic; Epidemiology; Exposure to; HIV; HIV Infections; Incidence; Infection; Infection prevention; Intervention; Knowledge; Morbidity - disease rate; NIH Program Announcements; Participant; Patients; Persons; Phase; Play; Policies; Population; Prevalence; Prevention; Prevention strategy; Preventive Intervention; Procedures; Prophylactic treatment; Protocols documentation; Publishing; RNA; Relative (related person); Risk; Risk Reduction; Role; Sampling; Services; Specificity; Specimen; Testing; United States National Institutes of Health; Virus; cost; cost effectiveness; economic cost; economic impact; indexing; mathematical model; mortality; novel; prevent; prevention service; programs; therapy development; transmission process

DESCRIPTION (provided by applicant): Novel intervention strategies are needed to reduce HIV incidence in the US below the current 40K plateau. The highly-infectious acute phase of initial infection represents a promising but relatively unexplored target for behavioral change interventions. Interventions that identify acutely-infected persons and help them reduce their risk of transmitting the virus to others could play an important role in efforts to reduce HIV incidence below the 40K plateau. However, the ultimate impact of these interventions depends on the actual extent of transmission during the acute phase of infection, as well as on the cost-effectiveness of potential interventions to reduce acute-phase HIV transmission. To enhance current understanding of the epidemiological impact of acute-phase HIV transmission and the cost-effectiveness of potential strategies to reduce HIV transmission during this period of elevated infectiousness, we will: 1) Develop mathematical models and procedures to estimate the annual number of incident HIV infections due to acute-phase transmission, the total number of such infections from 1998 through 2004, and the potential epidemiological and economic impact of interventions to reduce acute-phase HIV transmission. 2) Assess the efficiency and cost-effectiveness of supplementing existing HIV counseling and testing services with HIV-RNA testing of pooled test samples to facilitate identification of acutely-infected persons and encourage behavioral risk reduction to prevent acute-phase HIV transmission. 3) Assess the costs and estimate the number of HIV infections averted by a comprehensive post-exposure prophylaxis program that combined antiretroviral prophylaxis with either a 2-session behavioral risk reduction intervention or a more intensive 5-session intervention. This project will provide estimates of the magnitude and consequences of acute-phase HIV transmission, and the potential economic efficiency of various intervention strategies to prevent transmission during the acute phase of infection. This information is needed by decision makers at federal, state, and local levels who must prioritize HIV prevention intervention development and implementation. The results will inform scientific and policy discussions on the importance of interventions to reduce acute-phase transmission.

描述（由申请人提供）：需要新的干预策略来降低美国的艾滋病毒发病率，使其低于目前的40 K平台。初始感染的高传染性急性期是行为改变干预的一个有希望但相对未探索的目标。识别急性感染者并帮助他们降低将病毒传染给他人的风险的干预措施，可以在将艾滋病毒发病率降低到40 K高原以下的努力中发挥重要作用。然而，这些干预措施的最终影响取决于感染急性期的实际传播程度，以及减少艾滋病毒急性期传播的潜在干预措施的成本效益。为了加强目前对急性期艾滋病毒传播的流行病学影响以及在这一传染性升高时期减少艾滋病毒传播的潜在战略的成本效益的理解，我们将：1）开发数学模型和程序，以估计每年因急性期传播而感染艾滋病毒的人数，1998年至2004年这类感染的总数，以及为减少急性期艾滋病毒传播而采取的干预措施的潜在流行病学和经济影响。2)评估以混合测试样本的HIV-RNA测试补充现有艾滋病毒咨询和测试服务的效率和成本效益，以促进识别急性感染者，并鼓励减少行为风险，以预防急性期艾滋病毒传播。3)评估成本，并估计通过全面的暴露后预防计划避免的艾滋病毒感染人数，该计划将抗逆转录病毒预防与2次行为风险降低干预或更密集的5次干预相结合。该项目将提供对急性期艾滋病毒传播的规模和后果的估计，以及在感染急性期预防传播的各种干预战略的潜在经济效益。这些信息是联邦、州和地方各级决策者所需要的，他们必须优先考虑艾滋病毒预防干预措施的制定和实施。研究结果将为科学和政策讨论提供信息，说明采取干预措施减少急性期传播的重要性。