Optimal Strategies for Management of HIV Disease

描述（由申请人提供）：在美国和欧洲，艾滋病治疗的进步显著降低了艾滋病相关的发病率和死亡率。最近，药品价格的下降和对全球艾滋病毒流行的日益重视，为非洲、亚洲和加勒比欠发达国家制定艾滋病毒治疗方案创造了巨大的势头。Freedberg博士在以患者为导向的HIV结果研究方面有着杰出的记录，他建议建立在10多年的经验基础上，研究替代HIV护理策略的临床影响、成本和成本效益，并扩大初级研究人员在这些领域发展技能的机会。研究将集中在三个主要领域：美国艾滋病毒的最佳管理策略，不同艾滋病毒检测策略的成本效益，以及欠发达国家使用抗逆转录病毒和机会性感染预防的各种策略的影响。这项建议有以下三个具体目标：

DESCRIPTION (provided by applicant): Improvements in HIV treatment have dramatically reduced AIDS-related morbidity and mortality in the United States and Europe. More recently, lower drug prices and an increased focus on the global HIV epidemic has created tremendous momentum toward the development of HIV treatment programs in less developed countries in Africa, Asia and the Caribbean. With a distinguished track record of patient-oriented HIV outcomes research, Dr. Freedberg proposes to build on over 10 years of experience examining the clinical impact, cost, and cost-effectiveness of alternative HIV care strategies and to expand opportunities for junior investigators to develop skills in these areas. Research will focus in three main areas: optimal management strategies for HIV in the US, the cost-effectiveness of different strategies for HIV testing, and the impact of various strategies for antiretroviral use and opportunistic infection prophylaxis in less developed countries. This proposal has the following three specific aims: 1) To provide mentoring for young investigators in patient-oriented research in HIV disease. 2) To use ongoing multidisciplinary HIV-related modeling and outcomes research as a platform for training young investigators. 3) To utilize these efforts to address critical HIV clinical management questions in a variety of US and international settings. Using methods of clinical epidemiology, decision analysis, and simulation modeling, Dr. Freedberg proposes to expand on the past decade of work to focus added time and energy into questions at the forefront of HIV management throughout the world. By providing increased mentoring to fellows and junior faculty in the methods of outcomes research, Dr. Freedberg will create a multiplicative effect in increasing research capability in this important area of HIV-related patient-oriented investigation.