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

 描述(由申请人提供)：黑人男男性行为者(BMSM)中艾滋病毒感染率的巨大差异不能用更高的危险行为参与度来解释，尤其是在年轻的MSM中。尽管几种预防干预措施有效，但缩小这些差距需要最大限度地让这些男性的社会和性网络参与进来。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，使用毒品的涉刑事司法(CJI)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，但它们在CJI BMSM网络和社区中的成功实施尚未得到证明。此外，确定干预对这些较大的社会单位的影响的研究是昂贵的，而且不容易采用随机对照试验方法。这项建议旨在利用系统动态方法，使用基于代理的模型(ABM)来评估对使用BMSM的CJI物质进行艾滋病毒预防和药物滥用干预的有效性。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、ABM和艾滋病毒临床护理提供方面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 Simony)，该平台包括按地理位置划分的关于人员和家庭的基准国家数据，以及目标人口的动态特征，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，我们的团队在这些县收集了用于模型参数化的数据。我们的方法将评估社会和行为变量与病毒和宿主因素之间的相互作用，以适应特定于时间、网络和环境的变化。我们的目标是：1)通过纳入个人层面的艾滋病毒传播和抑制概率，包括宿主/病毒因素以及来自艾滋病毒预防和药物滥用干预研究的生物/行为数据，建立灵活的ABM；2)将ABM参数化，每个城市的调查人员可以在BMSM从社区到监狱，再到社区/监管的特定过渡时期提供多个网络数据来源；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补充这些数据(n=50个/城市)，特别是关于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的数据；3)使用AIM 2中参数化的模型在刑事司法背景下模拟艾滋病毒预防干预。由于我们的开放访问Repast Simony ABM平台被广泛使用，我们将公开提供模型参数、规范和变量。这将允许外部验证我们的调查结果，并允许其他人更多地使用核心模式，以便在高危人群中制定针对具体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.