Targeting Acute HIV

描述（由申请人提供）：拟议的项目，题为“靶向急性艾滋病毒”，涉及北卡罗来纳州主动传播筛查和追踪计划（STAT）的评估，优化和扩展。正如目前在全州范围内实施的那样，STAT计划涵盖了北卡罗来纳州所有公共资助的常规艾滋病毒咨询和检测（每年n= 120,000）。通过在公共卫生中央国家实验室使用新的标本池和艾滋病毒RNA检测方法，STAT规定在这一人群中检测非常早期的急性艾滋病毒感染。通过这些方法发现的急性艾滋病毒病例触发由专业疾病干预专家组成的特别小组立即启动确认性检测、网络通知和伴侣筛查。STAT计划正在前瞻性地收集关于急性病例及其接触者的广泛数据，从而为在大地理区域内发生的活跃艾滋病毒传播提供一个独特的窗口。本申请中描述的拟议研究利用这些数据，以解决我们目前对艾滋病毒传播及其预防的理解中的重大差距。我们组建了一支经验丰富的调查小组，以便：评估以初级保健为基础的大规模急性艾滋病毒筛查和伴侣通知规划的影响和效果；2. 表征急性艾滋病毒感染，因为它呈现在NC的常规检测人群，并制定诊断策略，针对初级保健为基础的急性艾滋病毒筛查；3. 描述在NC社区中有意或无意传播HIV的HIV阳性个体的人群；和4。执行详细的成本效益模型，以优化艾滋病毒预防的急性艾滋病毒为中心的努力。

DESCRIPTION (provided by applicant): The proposed project, entitled "Targeting Acute HIV," involves the evaluation, optimization and extension of North Carolina's Screening and Tracing of Active Transmission Program (STAT). As presently implemented statewide, the STAT Program encompasses all publicly funded routine HIV counseling and testing in NC (n= 120,000 annually). STAT provides for detection of very early acute HIV infections in this population by using novel specimen pooling and HIV RNA detection methods in a central State Laboratory of Public Health. Cases of acute HIV identified by these methods trigger initiation of immediate confirmatory testing, network notification and partner screening by a special team of professional Disease Intervention Specialists. The STAT program is prospectively collecting extensive data on acute cases and their contacts, thereby providing a unique window on active HIV transmission taking place over a large geographic area. The proposed research described in this application capitalizes on these data in order to address significant gaps in our current understanding of HIV transmission and its prevention. We have assembled an experienced team of investigators in order to: 1. Evaluate the impact and performance of a large scale, primary care-based acute HIV screening and partner notification program; 2. Characterize acute HIV infection as it presents in NC's routine testing population, and develop diagnostic strategies for targeting primary care-based acute HIV screening; 3. Describe a population of HIV positive individuals who are either knowingly or unknowingly transmitting HIV in NC communities; and 4. Perform detailed cost effectiveness modeling in order to optimize acute HIV-centered efforts at HIV prevention.