HIV intervention models for criminal justice involved substance-using Black MSM

 描述（由申请人提供）：与男性发生性关系的黑人男性（BMSM）的艾滋病毒感染率存在很大差异，这并不能用更高的风险行为来解释，而且在年轻的MSM中尤其高。尽管一些预防干预措施有效，但要缩小这些差距，就需要采取最大限度地利用这些男子的社会和性网络的办法。由于经常短暂的生活环境，社会和性网络的破坏以及艾滋病毒传播与其他群体重叠，使用药物的涉及刑事司法（CJI）的BMSM是干预的重要目标。虽然存在针对CJI人群的有效行为和结构干预措施，但尚未证明其在CJI BMSM网络和社区中的成功实施。此外，确定这些较大社会单位的干预影响的研究费用高昂，而且不容易采用随机对照试验方法。该提案旨在利用系统动态方法，使用基于代理的模型（ABM）来估计CJI物质使用BMSM的艾滋病毒预防和物质滥用干预措施的有效性。 我们的项目汇集了在BMSM，刑事司法环境，药物滥用干预，社会网络分析，ABMs和艾滋病毒临床护理提供研究中具有良好记录的调查人员。我们将采用以前开发的核心开放访问ABM平台（使用Repast Simphony），其中包括按地理位置划分的人员和家庭的基线国家数据，以及目标人群的动态特征，如监禁，健康中心和活动（时间使用）数据。我们将把ABM扩展到三个县：德克萨斯州哈里斯、加利福尼亚州洛杉矶和伊利诺伊州库克，我们的团队已经在那里收集了模型参数化的数据。我们的方法将评估社会和行为变量与病毒和主机因素之间的相互作用，这将适应时间，网络和设置特定的变化。我们的目标是：1）在我们灵活的ABM的基础上，通过在个体水平上整合HIV传播和抑制概率，包括来自HIV预防和药物滥用干预研究的宿主/病毒因素和生物/行为数据; 2）将每个城市的调查人员可获得的多个网络数据源参数化为ABM，用于BMSM从社区，监狱和返回社区/监督的特定过渡期;这种“冲击”导致社会和性网络的形成和破坏。我们将用新收集的数据（n=50/城市）补充这些数据，特别是在这些关键过渡时期的网络冲击和艾滋病毒预防和治疗利用率; 3）使用目标2中的参数化模型模拟刑事司法背景下的艾滋病毒预防干预措施。由于我们的开放访问Repast Simphony ABM平台被广泛使用，我们将使模型参数，规格和变量可用。这将使我们的研究结果得到外部验证，并使其他人更多地使用核心模式，在高危人群中制定针对具体情况和社区的艾滋病毒综合预防和治疗规划。

 DESCRIPTION (provided by applicant): Large disparities in HIV rates in black men who have sex with men (BMSM) are not explained by higher engagement in risky behaviors and are particularly high among younger MSM. Despite the efficacy of several prevention interventions, reducing these disparities requires approaches that maximally engage these men's social and sexual networks. Because of frequently transient life circumstances, disruption of social and sexual networks and HIV transmission overlap with other groups, criminal justice involved (CJI) BMSM who use substances represent an important target for intervention. Although effective behavioral and structural interventions exist that target CJI populations, their successful implementation for CJI BMSM networks and communities has not been demonstrated. Furthermore, research to determine intervention impact at these larger social units is costly and does not readily lend itself to the randomized control trial approach. This proposal aims to utiliz a systems dynamic approach using an agent-based model (ABM) to estimate the effectiveness of HIV prevention and substance-abuse interventions for CJI substance-using BMSM. Our project brings together investigators with a proven track record in the study of BMSM, criminal justice settings, substance-abuse intervention, social network analysis, ABMs and HIV clinical care provision. We will adapt a previously developed core open access ABM platform (using Repast Simphony) that includes baseline national data on people and households by geography, as well as the dynamic features of the target population such as incarceration, health center, and activity (time-use) data. We will scale the ABM to three counties: Harris TX, Los Angeles CA, and Cook IL where our team has collected data for model parameterization. Our approach will assess the interplay between social and behavioral variables and viral and host factors in a matter that will be adaptive to temporal, network and setting-specific changes. Our aims are to: 1) Build upon our flexible ABM by incorporating HIV transmission and suppression probabilities at the individual level, including host/viral factors and biologic/behavioral data from HIV prevention and substance-abuse intervention studies; 2) Parameterize this ABM with multiple network data sources available to investigators in each city on specific transition periods of BMSM from the community, to jail, and back to the community/ supervision; such "shocks" lead to social and sexual network formation and disruption. We will supplement these data with newly collected data (n=50/city) specifically on network shocks and HIV prevention and treatment utilization during these critical transition periods; 3) Simulate HIV prevention interventions within criminal justice contexts using the model parameterized in Aim 2. Because our open access Repast Simphony ABM platform is widely used, we will make model parameters, specifications and variables publically available. This will allow for external validation of our findings and for additional use of the core model by others for context and community-specific integrated HIV prevention and treatment planning in at risk populations.