Making Better Decisions: Policy Modeling for AIDS and Drug Abuse

描述（由申请人提供）：尽管最近在艾滋病毒和药物使用的预防和治疗干预措施方面取得了许多进展，但决策者和提供者被迫面临资金持续不足的问题，并在对稀缺资源的竞争中做出艰难的选择。在这次更新申请中，我们建议继续努力解决有关全球艾滋病毒预防、治疗和药物使用人群优先事项设定的新问题。我们将通过评估预防和治疗干预措施的组合，通过在共同流行病（艾滋病毒，丙型肝炎病毒感染和结核病）的背景下解决这些干预措施，并通过开发资源分配工具，扩展我们以前的流行病学建模工作。我们工作的目标是使用流行病学建模，以帮助决策者优化人口健康，通过提供信息的比较有效性，成本效益和替代投资组合的可负担性。我们的目标是：1.估计生产函数，其特征在于项目支出和健康相关结果之间的关系，例如预防项目的传播风险降低和治疗项目的服务提供。 2.开发基于模型的方法，将艾滋病毒相关干预措施的行为和生物影响转化为流行病结果，例如避免感染和挽救生命的年数。 3.确定如何最好地估计艾滋病毒和药物使用干预措施的健康结果、成本和成本效益（例如，在存在共同流行病的情况下）。 4.评估旨在预防和治疗艾滋病毒和药物使用及相关并发流行病（例如，HIV、HCV和结核病）。 5.通过在区域疾病流行病学背景下审查预防和治疗干预措施组合的有效性和成本效益，为社会资源的分配提供信息。 6.为政策制定者开发实用的资源分配工具，以协助他们在知情的情况下将资源投资于艾滋病毒和药物使用治疗和预防方案。我们拟议的研究将开发创新的流行病学建模方法，用于评估干预措施的组合;批判性地评估有前途的预防和治疗干预措施;推进艾滋病毒规划和政策建模的最新发展;并为规划人员提供创新工具，以帮助他们在知情的情况下分配稀缺的资源用于艾滋病毒和物质使用预防和治疗。拟议的工作将使我们能够对美国和国际上的艾滋病毒和药物使用政策产生广泛的影响。

DESCRIPTION (provided by applicant): Despite many recent advances in prevention and treatment interventions for HIV and substance use, policymakers and providers have been forced to confront a persistent insufficiency of funds and to make difficult choices from among competing claims on scarce resources. In this renewal application, we propose to continue our work to address emerging questions about global HIV prevention, treatment, and priority setting in substance-using populations. We will extend our prior epidemiologic modeling work by assessing portfolios of prevention and treatment interventions, by addressing these interventions in the context of co-epidemics (HIV, hepatitis C virus infection, and tuberculosis), and by developing resource allocation tools. The goal of our work is to use epidemiologic modeling to help decision makers optimize population health by providing information on the comparative effectiveness, cost-effectiveness, and affordability of alternative portfolio investments. Our aims are: 1. To estimate production functions that characterize the relationship between program expenditures and health-related outcomes, such as reductions in transmission risk for prevention programs and the delivery of services for treatment programs. 2. To develop model-based methods to translate the behavioral and biological impact of HIV-related interventions into epidemic outcomes, such as infections averted and years of life saved. 3. To determine how best to estimate health outcomes, costs, and cost-effectiveness of HIV and substance use interventions (for example, in the presence of co-epidemics). 4. To assess the individual- and population-level effectiveness, cost, cost-effectiveness, and budget impact of specific interventions aimed at preventing and treating HIV and substance use and related co-epidemics (e.g., HIV, HCV, and tuberculosis). 5. To inform the allocation of societal resources by examining the effectiveness and cost- effectiveness of portfolios of prevention and treatment interventions in the context of the regional epidemiology of disease. 6. To develop practical resource allocation tools for policymakers to assist them in making informed investments of resources in HIV and substance use treatment and prevention programs. Our proposed research will develop innovative epidemiologic modeling methods for assessing portfolios of interventions; critically evaluate promising prevention and treatment interventions; advance the state of the art in HIV planning and policy modeling; and provide planners with innovative tools to assist them in informed allocation of scarce resources for HIV and substance use prevention and treatment. The proposed work will enable us to have broad impact on HIV and substance use policy in the U.S. and internationally.