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Making Better Decisions: Policy Modeling for AIDS and Drug Abuse

做出更好的决策：艾滋病和药物滥用的政策建模

基本信息

批准号：
10310415
负责人：
DOUGLAS K OWENS
金额：
$ 67.64万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-09-25 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10310415
关键词：
Acquired Immunodeficiency Syndrome Address Adherence Clinical Trials Diagnosis Disease Outbreaks Drug abuse Effectiveness Epidemic Epidemiology Foundations Funding Gender Grant Guidelines HCV screening HIV HIV/HCV Health Hepatitis C Hepatitis C Incidence Hepatitis C Therapy Hepatitis C Transmission Hepatitis C virus Incidence Individual Injections International Intervention Length Life Expectancy Male Circumcision Measures Modeling Monitor Morbidity - disease rate Naloxone National Institute of Drug Abuse Needles Opioid Outcome Overdose Peer Review Persons Pharmaceutical Preparations Policies Population Prevalence Prevention Prevention strategy Public Health Publishing Quality of life Quality-Adjusted Life Years Race Research Resources Work addiction base epidemiological model experience implementation barriers improved injection drug use medication-assisted treatment mortality opioid epidemic opioid overuse opioid use opioid use disorder overdose death population health pre-exposure prophylaxis prevent programs psychosocial recruit response retention rate screening stem substance use transmission process virus identification

项目摘要

Project Summary/Abstract Opioid overuse, injection drug use, and overdose have become a national public health crisis, with over 60,000 drug overdose deaths in 2016 in the US, most involving opioids. Our objective is to conduct model-based studies that estimate the epidemiologic consequences of opioid use on HIV and HCV, including the benefits, harms, and resource use of opioid prevention and mitigation strategies. We will assess how best to reduce the incidence of HIV and HCV associated with opioid use and to improve quality of life for people with co- occurring HIV or HCV and opioid use disorder. Our aims are to: 1. Model the effect of the opioid epidemic on transmission of HIV and HCV. We will model the implications of the opioid epidemic on HIV and HCV incidence, prevalence, concentration in subpopulations, gender- and race-based differences. 2. Model the epidemiologic and population impacts of individual strategies to prevent and mitigate the harms of opioids and drug injection on HIV and HCV outcomes. We will evaluate prevention strategies including adaptive screening for HIV and HCV to aid in outbreak and hotspot identification, changing prescribing practices and monitoring programs, HIV pre-exposure prophylaxis (PrEP), intensive HIV and HCV screening, and mitigation strategies including medications for addiction treatment, psychosocial interventions, and distribution of naloxone. 3. Model the epidemiologic and population impact of portfolios of strategies to mitigate the harms of opioid use and drug injection on HIV and HCV outcomes. Because no single strategy will likely have sufficient impact on population health outcomes, we will examine sets of the strategies described in Aim 2 to assess which combinations have the potential for the largest epidemiologic impact on morbidity and mortality. 4. Model the impact of barriers to implementation of effective strategies and portfolios of strategies to reduce the harms of opioid use on HIV and HCV. We will model the effects of barriers to implementation steps (e.g., recruitment, referral, participation, and retention) for strategies identified in Aims 2 and 3. The proposed work will provide clinicians and policymakers with critically needed guidance about how combinations of strategies can efficiently mitigate the national public health crisis from opioid use and how such interventions can be integrated to reduce incidence of HIV and HCV and to improve both length and quality of life for people with HIV, HCV, and opioid use.

项目总结/文摘