Using geospatial science to maximize the opportunity to access ART in Africa

利用地理空间科学最大限度地增加非洲获得抗逆转录病毒治疗的机会

• 批准号: 10403396
• 负责人: Sally Margaret Blower
• 金额: $ 78.99万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-17 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10403396
• 关键词: Acquired Immunodeficiency Syndrome; Adopted; Africa; Africa South of the Sahara; African; Area; COVID-19; Caring; Collaborations; Country; Data; Data Set; Economics; Epidemic; Face; Geographic Distribution; Geography; HIV; Health care facility; Healthcare; Healthcare Systems; Hot Spot; Incidence; Individual; Inequality; Interruption; Intervention; Location; Malawi; Methods; Modeling; Pattern; Persons; Population; Prevalence; Process; Resources; Sampling; Science; Series; Spatial Distribution; Surveys; Travel; antiretroviral therapy; base; design; disparity reduction; geographic disparity; health care availability; health data; low income country; mathematical model; model design; novel; population based; programs; theories; tool

PROJECT SUMMARY / ABSTRACT This proposal is to develop and implement methods for quantifying geographic disparities, within Sub-Saharan African countries, in the opportunity for people living with HIV (PLHIV) to access antiretroviral therapy (ART); and to identify optimal strategies for reducing such disparities. The methods that we will develop constitute a novel analytic framework, which we will use to complete our three Specific Aims: (1) First, we will develop a spatial interaction model which can be applied in any SSA country to estimate the geographic opportunity to access ART and to identify disparities in this opportunity. We will apply the model to Malawi, which has one of the most severe HIV epidemics in the world, and where our previous studies have shown that PLHIV face substantial geographic disparities in accessing HIV care. To do so we will analyze a series of datasets, including the nationwide Malawi Population-based HIV Impact Assessments [MPHIAs]; the MPHIAs were collected in 2015/16 and 2020/21, spanning a period when ART coverage increased substantially. (2) Second, we will quantify the geographic relationship between the opportunity to access ART and its actual utilization, and determine the degree to which this relationship changed between the two timepoints. (3) Third, we will use our modeling framework in further analyses of the MPHIA 2020/21 dataset with the objective of identifying optimal strategies to reduce geographic disparities in the opportunity to access ART; both through the location of new healthcare facilities (HCFs) and through the allocation of additional supplies of ART. We will conduct these studies through a U.S.-Malawi collaborative team.

项目概要/摘要 该提案旨在制定和实施量化撒哈拉以南地区地理差异的方法 非洲国家为艾滋病毒感染者（PLHIV）提供获得抗逆转录病毒治疗（ART）的机会； 并确定减少这种差异的最佳策略。我们将开发的方法构成了 新颖的分析框架，我们将用它来完成我们的三个具体目标：（1）首先，我们将开发一个 空间相互作用模型可应用于任何 SSA 国家，以估计地理机会 获取 ART 并找出这一机会中的差异。我们将把该模型应用到马拉维，该国拥有以下之一： 世界上最严重的艾滋病毒流行，我们之前的研究表明，艾滋病毒感染者面临着 在获得艾滋病毒护理方面存在巨大的地理差异。为此，我们将分析一系列数据集，包括 马拉维全国基于人口的艾滋病毒影响评估[MPHIA]； MPHIA 收集于 2015/16 和 2020/21，这段时期 ART 覆盖率大幅增加。 （二）其次，我们将 量化获得 ART 的机会与其实际利用率之间的地理关系，以及 确定两个时间点之间这种关系变化的程度。 (3) 第三，我们将利用我们的 进一步分析 MPHIA 2020/21 数据集的建模框架，旨在确定最佳 减少获得抗逆转录病毒治疗机会的地理差异的战略；都通过新的位置 医疗机构 (HCF) 以及通过分配额外的 ART 用品。我们将进行这些 通过美国-马拉维合作团队进行研究。