A computer simulation of the Sub-Saharan HIV pandemic that can estimate benefit a

撒哈拉以南艾滋病毒大流行的计算机模拟可以估计收益

• 批准号: 8135604
• 负责人: Ronald Scott Braithwaite
• 金额: $ 43.46万
• 依托单位: NEW YORK UNIVERSITY SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8135604
• 关键词: AIDS prevention; Accidents; Acquired Immunodeficiency Syndrome; Address; Adherence; Africa South of the Sahara; African; Alcohol abuse; Alcohol consumption; Alcoholism; Alcohols; Anti-Retroviral Agents; Area; Behavioral; Benchmarking; Biological; Calibration; Caring; Cessation of life; Characteristics; Clinical; Clinical Research; Clinical Trials; Collaborations; Complex; Computer Simulation; Country; Data; Databases; Death Rate; Development; Ensure; Environment; Epidemic; Epidemiologist; Epidemiology; Funding; Guidelines; HIV; HIV Infections; High Prevalence; Incidence; Individual; Infection; Institutes; Intention; International; International AIDS; Intervention; Laboratories; Lead; Life; Life Expectancy; Male Circumcision; Mentored Patient-Oriented Research Career Development Award; Methods; Mission; Modeling; Monitor; National Institute of Allergy and Infectious Disease; National Institute on Alcohol Abuse and Alcoholism; Occupations; Opportunistic Infections; Outcome; Patients; Pattern; Persons; Pharmaceutical Preparations; Play; Policies; Policy Maker; Population; Prevalence; Research; Resources; Risk; Risk Behaviors; Sexually Transmitted Diseases; Simulate; Social Network; Symptoms; Testing; Time; Tuberculosis; Unsafe Sex; Validation; alcohol intervention; antiretroviral therapy; base; burden of illness; clinical care; clinically significant; cohort; condoms; cost; design; experience; hazard; member; model development; models and simulation; mortality; multidisciplinary; pandemic disease; prevent; sex; simulation; social; transmission process; trend

DESCRIPTION (provided by applicant): NIAAA PA-07-028 calls for studies to identify and model "the impact of alcohol consumption patterns on the spread of HIV infection and associated opportunistic infections over time" and "the prevention of HIV risk behaviors related to alcohol." In addition, NIAAA research objectives are increasingly targeting resource- poor settings because of their disproportionate burden of disease. To address these priorities, we aim to create a computer simulation of the HIV pandemic that can evaluate the benefit and value of NIAAA-funded interventions in Sub-Saharan Africa. To ensure that this model reflects the clinical realities of Sub-Saharan Africa as well as the particular features of the alcohol interventions under study, we have assembled a multidisciplinary team of modelers, alcohol experts, HIV experts, statisticians, and epidemiologists; including two PIs of the NIAAA-funded alcohol interventions that are under study. Virtually all of the study team members have extensive experience with clinical care or research in Sub-Saharan Africa. We will use the NIAID-funded, 34,000-patient, International Epidemiologic Databases to Evaluate AIDS (IeDEA) cohort to ensure that the simulation has good predictive validity, and we will design the simulation to represent important social features of HIV transmission in Sub-Saharan Africa (e.g., high prevalence of sexually transmitted infections, social network characteristics, etc). After constructing the simulation and ascertaining that it can predict individual- level and population-level Sub-Saharan outcomes, we will use the simulation to investigate whether NIAAA- funded interventions (1) lead to clinically significant benefits, (2) deliver greater value than WHO guidelines, and (3) deliver greater value than current care. Modeling is a method that is particularly well suited to assess the value of NIAAA-funded Sub-Saharan interventions because clinical trials will only provide short-term behavioral data, and comparing their benefit and value on a "level playing field" requires estimation of longer- term clinical outcomes. The National Institute of Alcoholism and Alcohol Abuse is studying many ways to decrease alcohol abuse and unprotected sex in regions of the world where HIV transmission risk is the highest. However, resources are very limited and we do not know which of these methods deliver the greatest value. This study aims to use well-tested computer simulation methods to help us assess and compare the value of different methods for preventing HIV transmission, with a focus on methods that specifically target alcohol abuse.

描述（由申请人提供）：NIAAA PA-07-028要求研究识别和建模“酒精消费模式对艾滋病毒感染传播的影响和相关的机会性感染随着时间的推移”和“预防与酒精有关的艾滋病毒风险行为”。“此外，NIAAA的研究目标越来越多地针对资源贫乏的环境，因为它们的疾病负担不成比例。为了解决这些优先事项，我们的目标是创建一个艾滋病毒流行病的计算机模拟，可以评估在撒哈拉以南非洲的NIAAA资助的干预措施的好处和价值。为了确保该模型反映了撒哈拉以南非洲的临床现实以及正在研究的酒精干预措施的具体特点，我们组建了一个由建模人员、酒精专家、艾滋病专家、统计学家和流行病学家组成的多学科团队;其中包括正在研究的NIAAA资助的酒精干预措施的两名PI。几乎所有的研究团队成员都在撒哈拉以南非洲地区拥有丰富的临床护理或研究经验。我们将使用NIAID资助的34，000名患者的国际流行病学数据库评估艾滋病（IEDEA）队列，以确保模拟具有良好的预测有效性，我们将设计模拟以代表撒哈拉以南非洲艾滋病毒传播的重要社会特征（例如，性传播感染流行率高、社会网络特征等）。在构建模拟并确定它可以预测撒哈拉以南地区的个人水平和人群水平的结果后，我们将使用模拟来调查NIAAA资助的干预措施是否（1）导致临床显著的益处，（2）提供比WHO指南更大的价值，以及（3）提供比当前护理更大的价值。建模是一种特别适合评估NIAAA资助的撒哈拉以南非洲干预措施价值的方法，因为临床试验仅提供短期行为数据，在“公平竞争环境”中比较其益处和价值需要估计长期临床结果。 国家酒精中毒和酒精滥用研究所正在研究多种方法，以减少世界上艾滋病毒传播风险最高的地区的酒精滥用和无保护性行为。然而，资源非常有限，我们不知道这些方法中哪一种提供最大的价值。这项研究旨在使用经过充分测试的计算机模拟方法来帮助我们评估和比较不同方法预防艾滋病毒传播的价值，重点是专门针对酗酒的方法。

项目成果

Impact of interventions targeting unhealthy alcohol use in Kenya on HIV transmission and AIDS-related deaths.

• DOI: 10.1111/acer.12332
• 发表时间: 2014-04
• 期刊: Alcoholism, clinical and experimental research
• 作者: Braithwaite RS;Nucifora KA;Kessler J;Toohey C;Mentor SM;Uhler LM;Roberts MS;Bryant K
• 通讯作者: Bryant K

HIV Treatment in Resource-Limited Environments: Treatment Coverage and Insights.

资源有限环境中的艾滋病毒治疗：治疗覆盖范围和见解。

• DOI: 10.1016/j.jval.2015.10.003
• 发表时间: 2015
• 期刊: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
• 作者: Khademi,Amin;Saure,Denis;Schaefer,Andrew;Nucifora,Kimberly;Braithwaite,RScott;Roberts,MarkS
• 通讯作者: Roberts,MarkS

Should expectations about the rate of new antiretroviral drug development impact the timing of HIV treatment initiation and expectations about treatment benefits?

• DOI: 10.1371/journal.pone.0098354
• 发表时间: 2014
• 期刊: PloS one
• 影响因子: 3.7
• 作者: Khademi A;Braithwaite RS;Saure D;Schaefer AJ;Nucifora K;Roberts MS
• 通讯作者: Roberts MS