Transportability of Causal Effects to Inform HIV Pre-exposure Prophylaxis Implementation

因果效应的可转移性为艾滋病毒暴露前预防的实施提供信息

• 批准号: 9197907
• 负责人: Megha Lynne Mehrotra
• 金额: $ 3.76万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9197907
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adherence; Behavior; Biometry; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinic; Clinical; Clinical Research; Clinical Trials; Communities; Control Groups; Counseling; Data; District of Columbia; Effectiveness; Effectiveness of Interventions; Ensure; Environment; Epidemic; Epidemiologist; Epidemiology; FDA approved; Face; Floods; Foundations; Future; Goals; Guidelines; HIV; HIV Infections; Incidence; Individual; Intention; Intervention; Mentors; Mentorship; Methods; Modeling; Monitor; National Institute of Mental Health; Oral; Play; Policies; Policy Maker; Population; Population Characteristics; Prevention; Prevention program; Prophylactic treatment; Public Health; Randomized; Recruitment Activity; Research; Research Infrastructure; Research Personnel; Research Priority; Rest; Risk; Role; Safety; San Francisco; Services; Sorting - Cell Movement; Strategic Planning; Structure; Subgroup; Target Populations; Testing; Training; United States National Institutes of Health; Work; base; career; cohort; demographics; implementation science; infancy; insight; men who have sex with men; novel; open label; optimism; programs; randomized placebo controlled trial; study population; success; transgender women; transmission process; treatment effect; truvada; uptake

Project Summary The long-term goal of this proposal is to apply causal inference methods to inform implementation of pre-exposure prophylaxis for HIV prevention (PrEP). PrEP is a proven biomedical intervention that has the potential to dramatically reduce the number of HIV infections globally, but insufficient adherence to PrEP is the biggest barrier to its effectiveness. Widespread implementation of PrEP is required to realize PrEP's full public health potential, and the most recent strategic plans and research priorities of NIH, PEPFAR, NIMH, and the Office of AIDS research all reflect the urgent need for more work in implementation science as it relates to HIV prevention. No single HIV prevention program is ideal for all contexts, and before PrEP is rolled out widely, policy- makers need to assess how PrEP should fit into their own HIV prevention programs. This will require estimating the anticipated public health impact of PrEP in each context, and identifying priority populations for targeted adherence support. Transportability provides a timely solution to these challenges currently facing the PrEP implementation field. Transportability is a novel mathematical framework for predicting the anticipated real-world effectiveness of interventions. The objective of this proposal is to use transportability to inform PrEP implementation by estimating PrEP's real-world effectiveness and identifying priority populations for adherence support. Using data from the iPrEx, iPrEx OLE, and PrEP DemoProjects, Aim 1 will illustrate how transportability can be applied to estimate the effectiveness of a randomized intervention in a distinct target population, and Aim 2 will clarify which characteristics and populations should be prioritized for adherence support. The proposed study will provide valuable and timely insight for PrEP implementation, and will serve as a model for estimating real-world effectiveness of PrEP in other target populations. The interdisciplinary training environment, expert mentorship, and use of cutting edge methods will provide the applicant an opportunity to develop unmatched subject matter, technical, and methodological expertise for her career as a future independent researcher in HIV prevention epidemiology.

项目摘要 这项提议的长期目标是应用因果推理方法来 实施暴露前预防艾滋病毒(PrEP)。Prep是一位久经考验的 生物医学干预有可能大幅减少全球艾滋病毒感染人数， 但对PrEP的坚持不足是其有效性的最大障碍。广泛实施 需要准备以实现PrEP的全部公共卫生潜力，以及最新的战略计划和研究 NIH、PEPFAR、NIMH和艾滋病研究办公室的优先事项都反映出迫切需要在以下方面开展更多工作 实施科学，因为它与艾滋病毒预防有关。 没有一个单一的艾滋病毒预防计划对所有情况都是理想的，在PrEP广泛推出之前，政策- 制造商需要评估PrEP应该如何适应他们自己的艾滋病毒预防计划。这将需要 评估每种情况下PrEP对公共卫生的预期影响，并确定优先人群 以获得有针对性的遵守支持。可移植性为当前的这些挑战提供了及时的解决方案 面向PrEP实施领域。 可移植性是预测预期现实世界的一种新的数学框架 干预措施的有效性。这项提议的目标是利用可运输性来通知 通过评估PrEP的实际有效性和确定优先级来准备实施 用于支持遵守的人口。使用来自Iprex、Iprex OLE和PrEP演示项目的数据，Aim 1将说明如何应用可移植性来评估随机干预的有效性 在不同的目标人群中，目标2将阐明哪些特征和人群应该 优先获得遵从性支持。 拟议的研究将为PrEP的实施提供宝贵和及时的见解，并将发挥以下作用 评估PrEP在其他目标人群中实际效果的模型。跨学科 培训环境、专家指导和尖端方法的使用将为申请者提供 为她的职业生涯培养无与伦比的主题、技术和方法专长的机会 未来在艾滋病毒预防流行病学方面的独立研究员。