Localized economic modeling to support implementation of the Ending the HIV Epidemic initiative

支持实施“终结艾滋病毒流行”倡议的本地化经济模型

• 批准号: 10255043
• 负责人: Bohdan Nosyk
• 金额: $ 56.39万
• 依托单位: SIMON FRASER UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-03-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10255043
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Advisory Committees; COVID-19; COVID-19 pandemic; Centers for Disease Control and Prevention (U.S.); Cities; Collaborations; Collection; Communication; Communities; Community Health; Cost Effectiveness Analysis; Country; County; Custom; Data; Decision Making; Development; Diagnosis; Disease Outbreaks; Dissemination and Implementation; Early Diagnosis; Economic Models; Effectiveness; Elements; Ensure; Epidemic; Epidemiology; Evidence based intervention; Funding; Geography; Goals; HIV; HIV Infections; HIV diagnosis; Health; Health Benefit; Health Services Accessibility; Health system; Human Resources; Infection; Infrastructure; Intervention; Justice; Latinx; Laws; Lead; Methodology; Modeling; Outcome; Output; Phase; Policies; Prevention; Public Health; Public Health Schools; Puerto Rico; Research; Research Personnel; Resources; Rural; Science; Services; Sexual Partners; Testing; Time; United States; United States Health Resources and Services Administration; Universities; Update; Washington; Work; base; care systems; cost effectiveness; dashboard; disparity reduction; economic evaluation; evidence base; flexibility; health care availability; health care disparity; health difference; health economics; health equity promotion; implementation process; implementation science; implementation strategy; improved; innovation; knowledge translation; models and simulation; novel strategies; pre-exposure prophylaxis; prevent; prevention service; racial and ethnic; rapid detection; response; scale up; service delivery; service intervention; service programs; tool; translational approach; transmission process; treatment services

Localized economic modeling to support implementation of Whe µEQdiQg Whe HIV ESidePic iQ APeUica¶ initiative Rather than a homogeneous national epidemic, the HIV epidemic in the United States is a collection of diverse local microepidemics concentrated primarily in the South, hotspot counties, and large urban centers, with fundamental differences in health system infrastructure, funding and HIV-related laws and policies across jurisdictions. Recognizing these facts, the US OaXQcKed WKe aPbLWLRXV µEQdLQJ WKe HIV ESLdePLc (EHE) LQLWLaWLYe LQ FebUXaU\ 2019. TKe SOaQ caOOed IRU an initial focus on 48 counties accounting for more than 50% of all new HIV diagnoses plus Washington, DC, San Juan, Puerto Rico and seven states with substantial rural burden to reduce new infections by 75% within 5 years and by 90% within 10 years. These goals are now challenged by the onset of the global COVID-19 pandemic, which may have severe consequences for people living with HIV and on HIV microepidemics across the US. Further, with widespread civil protest demanding racial justice across the US, a value-based approach that accounts for the pervasive racial/ethnic inequities in healthcare access and explicating key elements of the implementation process needed to reach optimal levels of service delivery are now more critical than ever in reaching the ambitious targets of the EHE initiative. We propose to renew our previously-funded R01 JUaQW eQWLWOed ³Localized economic modeling for the treatment and prevention of HIV/AIDS´ (R01-DA0041747). In this competitive renewal application, we propose an integrated set of aims, executed in parallel, with the goal of establishing a decision-making platform that considers all strategies relevant to communities and decision-makers in EHE-targeted jurisdictions, acknowledges COVID-19-related disruptions in access to services, and integrates new evidence as it emerges. We propose to expand our focal set of evidence-based interventions to Diagnose, Treat and Prevent HIV infection to also consider the potential impact of the Respond pillar of the EHE initiative; to work with local communities and public health officials to refine and tailor our analysis to local needs and constraints; and to extend our geographic focus to cover each of the jurisdictions targeted in phase 1 of the EHE initiative, applying a novel approach, distributional cost-effectiveness analysis, to simultaneously maximize the impact of local HIV responses and reduce racial/ethnic inequities in healthcare access.

本地化经济建模，以支持实施Whe µEQdiQg Whe HIV ESidePic iQ APeUica¶计划 美国的艾滋病流行不是一种单一的全国性流行病，而是一种不同的地方性流行病的集合。 微流行病主要集中在南部、热点县和大城市中心， 在卫生系统基础设施、资金和艾滋病毒相关的法律和政策方面，认识到这些事实， US OaXQcKed WKe aPbLWLRXV µEQdLQJ WKe HIV ESLdePLc（EHE）LQLWLLaWLYe LQ 2019年2月。TKe SOaq将IRU称为初始 重点关注48个县，这些县占所有新艾滋病毒诊断的50%以上，加上华盛顿、哥伦比亚特区、圣胡安、波多黎各 以及7个农村负担沉重的州，在5年内将新感染率降低75%，在10年内降低90%。 这些目标现在受到全球COVID-19大流行的挑战，这可能对 艾滋病毒感染者和艾滋病毒微流行病在美国。此外，随着广泛的民间抗议要求种族 美国各地的正义，一种基于价值的方法，解释了医疗保健服务中普遍存在的种族/民族不平等 并阐明实现最佳服务交付水平所需的实施过程的关键要素， 在实现EHE计划的宏伟目标方面，这比以往任何时候都至关重要。 我们建议更新我们以前资助的R 01 JUaQW eQWLWOed治疗的本地化经济模型 和预防HIV/AIDS（R 01-DA 0041747）。在这个竞争性的续约申请中，我们提出了一套完整的 目标，目标是建立一个决策平台，考虑与以下方面有关的所有战略： EHE目标管辖区的社区和决策者，承认与COVID-19相关的访问中断， 服务，并整合新的证据，因为它出现。我们建议扩大我们的循证干预重点， 诊断、治疗和预防艾滋病毒感染，同时考虑到教育、健康和环境倡议应对支柱的潜在影响; 与当地社区和公共卫生官员合作，根据当地需求和限制因素完善和调整我们的分析; 并扩大我们的地理重点，以涵盖EHE倡议第一阶段目标的每个司法管辖区， 一种新的方法，即分配成本效益分析，以同时最大限度地发挥当地艾滋病毒应对措施的影响 减少医疗保健服务中的种族/民族不平等。