HIV intervention models for criminal justice involved substance-using Black MSM

刑事司法的艾滋病毒干预模型涉及使用药物的黑人男男性接触者

• 批准号: 9271423
• 负责人: Kayo Fujimoto
• 金额: $ 0.84万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-01 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9271423
• 关键词: AIDS prevention; Accounting; Acquired Immunodeficiency Syndrome; Address; Adherence; Affordable Care Act; Alcohol or Other Drugs use; Back; Behavior; Behavioral; Biological Factors; Caring; Chicago; Cities; Clinical Trials; Communicable Diseases; Communities; Community Networks; Complex; County; Couples; Criminal Justice; Data; Data Sources; Disease; Drug usage; Effectiveness; Event; Friends; Future; Geography; HIV; HIV Infections; Health; Household; Imprisonment; Incidence; Individual; Institution; Integration Host Factors; Intervention; Intervention Studies; Jail; Laboratories; Lead; Left; Life; Link; Los Angeles; Marijuana; Modeling; Pathway Analysis; Policies; Population; Populations at Risk; Prevention; Preventive; Preventive Intervention; Probability; Publishing; Randomized Controlled Trials; Research; Research Personnel; Risk; Risk Behaviors; Role; Services; Sexually Transmitted Diseases; Shock; Social Environment; Social Network; Specific qualifier value; Staging; Structure; Substance abuse problem; Supervision; Systems Analysis; Target Populations; Time; United States; Validation; Viral; Work; base; black men who have sex with men; clinical care; cooking; cost; data modeling; disparity reduction; dynamic system; flexibility; intervention effect; mathematical model; men; men who have sex with men; network models; scale up; service utilization; simulation; social; time use; transmission process; treatment planning

 DESCRIPTION (provided by applicant): Large disparities in HIV rates in black men who have sex with men (BMSM) are not explained by higher engagement in risky behaviors and are particularly high among younger MSM. Despite the efficacy of several prevention interventions, reducing these disparities requires approaches that maximally engage these men's social and sexual networks. Because of frequently transient life circumstances, disruption of social and sexual networks and HIV transmission overlap with other groups, criminal justice involved (CJI) BMSM who use substances represent an important target for intervention. Although effective behavioral and structural interventions exist that target CJI populations, their successful implementation for CJI BMSM networks and communities has not been demonstrated. Furthermore, research to determine intervention impact at these larger social units is costly and does not readily lend itself to the randomized control trial approach. This proposal aims to utiliz a systems dynamic approach using an agent-based model (ABM) to estimate the effectiveness of HIV prevention and substance-abuse interventions for CJI substance-using BMSM. Our project brings together investigators with a proven track record in the study of BMSM, criminal justice settings, substance-abuse intervention, social network analysis, ABMs and HIV clinical care provision. We will adapt a previously developed core open access ABM platform (using Repast Simphony) that includes baseline national data on people and households by geography, as well as the dynamic features of the target population such as incarceration, health center, and activity (time-use) data. We will scale the ABM to three counties: Harris TX, Los Angeles CA, and Cook IL where our team has collected data for model parameterization. Our approach will assess the interplay between social and behavioral variables and viral and host factors in a matter that will be adaptive to temporal, network and setting-specific changes. Our aims are to: 1) Build upon our flexible ABM by incorporating HIV transmission and suppression probabilities at the individual level, including host/viral factors and biologic/behavioral data from HIV prevention and substance-abuse intervention studies; 2) Parameterize this ABM with multiple network data sources available to investigators in each city on specific transition periods of BMSM from the community, to jail, and back to the community/ supervision; such "shocks" lead to social and sexual network formation and disruption. We will supplement these data with newly collected data (n=50/city) specifically on network shocks and HIV prevention and treatment utilization during these critical transition periods; 3) Simulate HIV prevention interventions within criminal justice contexts using the model parameterized in Aim 2. Because our open access Repast Simphony ABM platform is widely used, we will make model parameters, specifications and variables publically available. This will allow for external validation of our findings and for additional use of the core model by others for context and community-specific integrated HIV prevention and treatment planning in at risk populations.

 描述（由申请人提供）：男男性行为黑人 (BMSM) 中艾滋病毒感染率的巨大差异不能用较高的危险行为参与率来解释，而且在年轻的男男性行为者中这一比例尤其高。尽管一些预防干预措施很有效，但要减少这些差异，就需要采取最大限度地参与这些男性的社交和性网络的方法。由于生活环境经常短暂、社会和性网络受到破坏以及艾滋病毒传播与其他群体重叠，使用药物的刑​​事司法涉及 (CJI) BMSM 是干预的重要目标。尽管存在针对 CJI 人群的有效行为和结构干预措施，但其在 CJI BMSM 网络和社区中的成功实施尚未得到证实。此外，确定干预措施对这些较大社会单位的影响的研究成本高昂，并且不容易采用随机对照试验方法。该提案旨在利用基于主体的模型 (ABM) 的系统动态方法来评估 CJI 物质使用 BMSM 的 HIV 预防和物质滥用干预措施的有效性。 我们的项目汇集了在 BMSM、刑事司法环境、药物滥用干预、社交网络分析、ABM 和 HIV 临床护理提供研究方面拥有良好记录的研究人员。我们将采用之前开发的核心开放访问 ABM 平台（使用 Repast Simphony），其中包括按地理位置划分的人和家庭的基准国家数据，以及目标人群的动态特征，例如监禁、健康中心和活动（时间使用）数据。我们将 ABM 扩展到三个县：德克萨斯州哈里斯县、加利福尼亚州洛杉矶县和伊利诺伊州库克县，我们的团队已在这些县收集了模型参数化的数据。我们的方法将评估社会和行为变量以及病毒和宿主因素之间的相互作用，以适应时间、网络和特定环境的变化。我们的目标是： 1) 在我们灵活的 ABM 基础上，纳入个体层面的 HIV 传播和抑制概率，包括宿主/病毒因素以及来自 HIV 预防和药物滥用干预研究的生物/行为数据； 2) 通过多个网络数据源对该 ABM 进行参数化，以供每个城市的调查人员使用，了解 BMSM 从社区、到监狱、再回到社区/监督的特定过渡时期；这种“冲击”导致社会和性网络的形成和破坏。我们将用新收集的数据（n=50/城市）补充这些数据，特别是关于这些关键过渡时期的网络冲击和艾滋病毒预防和治疗利用情况； 3) 使用目标 2 中参数化的模型模拟刑事司法背景下的艾滋病毒预防干预措施。由于我们的开放获取 Repast Simphony ABM 平台得到广泛使用，我们将公开提供模型参数、规格和变量。这将允许对我们的研究结果进行外部验证，并允许其他人额外使用核心模型，以针对高危人群制定针对具体情况和社区的综合艾滋病毒预防和治疗规划。