Assessing the Impact of Economic Policies on the Use of Pre-Exposure Prophylaxis in the United States

项目总结 虽然 涉及到 准备 案例 变化 基于， 项目将 政策， 对避孕套使用和艾滋病毒检测的二次影响。 社会行为 他们的 2. MSM。 准备 这些 数学 政策 这样的 最近的联邦和州政策旨在鼓励PrEP(暴露前预防)- (A)实现基于药房的PrEP交付1，(B)利用医疗补助计划的好处来促进 (即，取消先前的授权、远程医疗提供的PrEP的覆盖范围和目标的超额 管理)2和(C)强制零成本分担3--被描述为最重要的 发生在PrEP 4-上的情况，其影响尚不清楚。通过实施一种理论- 多层次、纵向分析公共卫生政策如何 确定有效实现结束艾滋病毒流行目标的政策。-13目标1将整合 处方数据、调查和消费者数据，以隔离政策对PrEP使用的影响 AIM 2将扩展我们的纵向数据库，以包括 使用PrEP的决定因素，包括态度、规范和行为控制，并探索 在公共卫生政策与PrEP摄取率和持久性之间的关系中的中介作用。目标1和 L：a)美国人口，(B)男男性接触者，(C)黑人、西班牙裔和白人 目标3将进一步审查目标1中研究的政策的有效性，从影响转向 对一般男男性接触者和黑人、西班牙裔和白人男男性接触者中HIV传播的影响进行建模。 通过将计量经济学、大数据、统计和 方法：研究方法。首先，差异差异法将比较干预区域 已经实施并控制了没有政策的地区，同时针对未测量的混杂因素进行了调整 因为文化或人口统计上的差异。第二，大数据分析 C 6. 影响PrEP的摄取和持久性，这 7. 和 ( S ， 将评估心理社会 不同地区使用PrEP的决定因素，并调查政策在诱导行为方面的作用 变化。第三, 的 重要信息 人口 授奖 这些结果将为艾滋病毒传播的基于代理的模型提供信息，该模型将预测影响 对男男性接触者的干预，考虑到国家种族/民族差异。Fayaz-Farkhad博士已经做出了 有助于了解针对边缘化群体的干预措施的有效性 他是一名有成就的初级研究员，在艾滋病毒领域拥有丰富的经验。这个K01 将通过以下几个关键领域的培训扩展她的发展轨迹：(一)艾滋病毒流行病学，(二)科学 (3)健康不平等；(4)高级方法技能。 提供 谁的 项目 横切 行为 拟建的K01将会 培训和指导，作为她作为独立调查员职业生涯的基础 研究将有助于改善易受艾滋病毒感染的人群的医疗保健机会。这 与NIAID的战略目标非常一致，并直接与艾滋病研究办公室保持一致 减少重点人群中艾滋病毒发病率的健康差距领域，并利用 和社会科学的艾滋病毒护理。

PROJECT SUMMARY Although involve PrEP case changes based, project will policies, secondary impact on condom use and HIV testing. social-behavioral their 2 MSM. PrEP These mathematical policy such recent federal and state policies targeted t o encourage PrEP (pre-exposure prophylaxis) — which (a) enabling pharmacy-based PrEP delivery 1 , (b) leveraging Medicaid program's benefits to promote (i.e., removal of prior authorization, coverage of telemedicine-delivered PrEP, and overage of targeted management) 2 , and (c) mandating zero-cost sharing 3 — have been described as the most significant that have happened with PrEP 4 – , their impact is not well understood. By implementing a theory- multi-level, longitudinal analysis of how public health policies identify policies to efficiently achieve the Ending the HIV Epidemic goals. – 13 Aim 1 will integrate prescription data, surveys, and consumer data to isolate the effects of the policies on PrEP use Aim 2 will expand our longitudinal database to include determinants of PrEP use, including attitudes, norms, and behavioral control, and explore mediating role in the relation between public health policies and PrEP uptake and persistence. Aims 1 and will mode l a) the US population, (b) MSM (men who have sex with men), and (c) Black, Hispanic, and White Aim 3 will f urther examine the effectiveness of the policies studied in Aim 1 by moving from effects on t o modeling effects on HIV transmission among MSM in general and Black, Hispanic, and White MSM. three aims will be achieved through an innovative combination of econometric, big data, tatistical, and methods. First, a difference in differences method will compare intervention areas in which a has been implemented and control areas without the policy while adjusting for unmeasured confounders as differences in culture or demographics. Second, big data analyses c 6 affect PrEP uptake and persistence, this 7 and ( s , will assess psychosocial determinants of PrEP use for different regions and investigate the role of the policies in eliciting behavioral change. Third, of important populations Award these results will inform an agent-based model of HIV transmission that will project the impact the interventions for MSM, taking into account national race/ethnic disparities. Dr. Fayaz-Farkhad has made contributions to understanding the effectiveness of interventions targeted for marginalized and is an accomplished junior researcher with ample experience in the field of HIV. This K01 will extend her trajectory with training in several key areas:(i) HIV epidemiology, (ii) the science of attitudes and behavior, (iii) health inequalities, and (iv) advanced methodological skills. provide whose project cross-cutting Behavioral The proposed K01 will training and mentorship to serve as the foundation for her career as an independent investigator research will serve to improve healthcare access for populations vulnerable to HIV infection. This is well-aligned with NIAID's strategic objectives and directly in line with the Office of AIDS Research areas of Health Disparities to reduce the incidence of HIV in priority populations and utilize and Social Sciences for HIV care.