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.

项目摘要/摘要 这项提议是在撒哈拉以南地区制定和实施量化地理差异的方法 非洲国家，使艾滋病毒携带者有机会获得抗逆转录病毒治疗(ART)； 并确定缩小这种差距的最佳战略。我们将开发的方法构成了 新的分析框架，我们将用它来完成我们的三个具体目标：(1)首先，我们将开发一种 空间相互作用模型，可应用于任何SSA国家，以估计地理机会 获取艺术，并找出这一机会中的差距。我们将把这个模型应用到马拉维，那里有一个 世界上最严重的艾滋病毒流行，我们之前的研究表明，PLHIV面临着 在获得艾滋病毒护理方面存在很大的地域差异。为此，我们将分析一系列数据集，包括 马拉维全国以人口为基础的艾滋病毒影响评估[MPHIA]；MPHIA收集于 2015/16年度和2020/21年度，期间艺术品覆盖面大幅增加。(2)第二，我们将 量化获得抗逆转录病毒治疗的机会与其实际利用之间的地理关系，以及 确定这两个时间点之间此关系的更改程度。(3)第三，我们将使用我们的 进一步分析MPHIA 2020/21数据集的建模框架，目的是确定最佳 减少获得抗逆转录病毒药物机会的地理差异的战略；既通过新的 通过分配额外的抗逆转录病毒治疗药物。我们将进行这些工作 通过美国-马拉维合作团队进行的研究。