Economic, health, and behavioral dimensions of HIV treatment scale-up

 描述：这一拟议的四年开发期将用于研究和培训活动，这些活动将使Bor博士获得成为独立调查员所需的技能和经验。鲍尔博士的长期职业目标是将经济学的理论和分析工具应用于人口健康研究，重点是艾滋病毒的治疗和预防。以定量数据分析的强大背景为基础，鲍尔博士提出了一项培训计划，以培养混合方法研究设计、内容领域的行为经济学专业知识以及因果推断的流行病学方法方面的技能。培训计划将包括正式的课程作业，特定主题的定向阅读，以及一个有指导的研究项目。这项研究将调查南非农村艾滋病毒治疗的扩大如何形成对艾滋病毒风险环境的信念，以及这些信念如何影响与艾滋病毒检测、性行为和人力资本投资(例如教育)相关的行为。虽然抗逆转录病毒疗法对艾滋病毒患者的健康益处已经有了很好的证明，但关于抗逆转录病毒疗法的可获得性增加如何影响社区层面的经济、健康和求医行为的了解较少。这些溢出效应对扩大抗逆转录病毒疗法的成本-效益分析具有影响，并可能为增加艾滋病毒检测、护理和治疗的干预措施提供信息。这项拟议的研究将结合对夸祖鲁-纳塔尔农村人口健康监测点现有数据的分析，并以混合方法设计收集主要的定性、调查和实验数据。将制定一项简短的干预措施，以增加艾滋病毒检测的使用率，并在随机评估中进行试点。

 DESCRIPTION: This proposed four-year development period will be used for research and training activities that will give Dr. Bor the skills and experience necessary to become an independent investigator. Dr. Bor's long-term career goal is to apply the theory and analytical tools of economics to the study of population health, with a focus on HIV treatment and prevention. Building on a strong background in quantitative data analysis, Dr. Bor has proposed a training plan to develop skills in mixed methods study designs, content area expertise in behavioral economics, and epidemiological approaches to causal inference. The training plan will involve formal coursework, directed readings on specific topics, and a mentored research project. The research will investigate how the scale-up of HIV treatment in rural South Africa has shaped beliefs about the HIV risk environment, and how these beliefs influence behaviors related to HIV testing, sexual behavior, and human capital investment (e.g., education). Although the health benefits of ART for HIV patients are well documented, less is known about how increased availability of ART has influenced economic, health, and care-seeking behaviors at the community level. These spillover effects have implications for cost-benefit analyses of ART scale-up, and may inform interventions to increase HIV testing, care, and treatment. The proposed research will combine analysis of existing data from a health and demographic surveillance site in rural KwaZulu-Natal with collection of primary qualitative, survey, and experimental data in a mixed methods design. A brief intervention to increase take up of HIV testing will be developed and piloted in a randomized evaluation.