Quantification of HIV burden and the biomedical, structural, and behavioral factors influencing HIV/AIDS among children and young adolescents

量化艾滋病毒负担以及影响儿童和青少年艾滋病毒/艾滋病的生物医学、结构和行为因素

• 批准号: 10366011
• 负责人: Hmwe Hmwe Kyu
• 金额: $ 69.56万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-03-05 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10366011
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adolescent; Adult; African; Age; Automobile Driving; Behavioral; Big Data; Birth; Caring; Cessation of life; Child; Childhood; Consensus; Country; Data; Data Analyses; Data Sources; Education; Epidemic; Exposure to; Fibrinogen; Future; Goals; HIV; HIV Infections; HIV-infected adolescents; Health; Human immunodeficiency virus test; Incidence; Infection; Intervention; Link; Location; Measures; Methods; Modeling; Monitor; Morbidity - disease rate; Policies; Population; Prevalence; Prevention; Probability; Risk; Risk Behaviors; Risk Factors; Role; Series; Sex Behavior; Sexual Partners; Source; Substance abuse problem; Time; Vertical Disease Transmission; Visualization; Visualization software; Woman; Work; age group; antiretroviral therapy; base; burden of illness; condoms; diverse data; health care quality; insight; mortality; pediatric human immunodeficiency virus; protective factors; rate of change; sex; sexual debut; statistics; tool; transmission process; trend

PROJECT SUMMARY/ABSTRACT HIV/AIDS is a leading cause of morbidity and mortality among children and adolescents, and it is well recognized that HIV care and treatment among children (birth to 9 years) and young adolescents (10-14 years) lags behind that of adults, leading to numerous calls to action. Despite a global consensus toward eliminating new HIV infections in these age groups, assessing progress against targets is impeded, as current estimates do not include substantial amounts of locally-available data. Additionally, new HIV infections in young adolescents have not been quantified. The global HIV burden in these age groups is currently estimated by two groups: the Global Burden of Disease (GBD) study and UNAIDS, both of which currently assume no new HIV infections for those under 15. Both groups use the Spectrum child model, which relies largely on estimated HIV prevalence among adult women, treatment for prevention of mother-to-child transmission, and other assumptions to estimate the HIV burden among children and young adolescents. One of the assumptions is that new HIV infections among those under 15 come from only one source – mother-to-child transmission – assuming no sexual activity and zero HIV incidence in young adolescents. In addition to behavioral factors, evidence shows that the risk of HIV transmission is influenced by biomedical factors (e.g., HIV testing rates, antiretroviral therapy coverage) and structural factors (e.g., national wealth, access to education, health care quality and access). However, there has been no systematic study of the impact of these factors on the trajectory of the HIV epidemic. Given the complexity of the epidemic and the interplay of contributing factors, additional data and analyses are needed to understand the relative impact of these factors. Developing methods to triangulate newly acquired data sources is crucial to enhancing understanding of the drivers of the epidemic, and to generating more robust HIV burden estimates for children and adolescents. Accordingly, the goal of this study is to address the limitations of existing methods by triangulating empirical data sources to produce more accurate and comprehensive estimates of pediatric HIV burden, including an understanding of how biomedical, behavioral, and structural factors impact the burden among children and adolescents. Our proposal advances beyond existing work by providing the first- ever estimates of new HIV infections among young adolescents, and by incorporating these results into an interactive visualization platform to help key stakeholders understand the current and projected future burden of HIV/AIDS among children and adolescents under different scenarios. This project is comprised of four Specific Aims: (1) Incorporate currently unused data sources to estimate mother-to-child transmission and HIV burden among children (0-9 years); (2) Estimate new infections among young adolescents (10-14 years); (3) Quantify the impact of biomedical, behavioral, and structural factors on HIV transmission probabilities and mortality among children and young adolescents; and (4) Forecast future burden of HIV among children and adolescents through 2040 based on current trends in incidence, prevalence, and mortality, and exposure to risk and protective factors.

项目摘要/摘要 艾滋病毒/艾滋病是儿童和青少年死亡死亡率的主要原因，这是众所周知的 儿童的艾滋病毒护理和治疗（9岁）和年轻的青少年（10-14岁）落后 成年人，尽管有全球性的共识，导致了许多呼吁 这些年龄段的感染，评估针对目标的进展受到阻碍，因为当前的估计不估计 包括大量本地可用数据。 这些年龄段的全球艾滋病毒负担尚未量化。 疾病负担（GBD）的研究和UNAID，目前均假定为这些新的新型HIV HIV HIV HIV HIV HIV HIV感染。 15岁以下。两组都使用Spectrum儿童模型，该模型依赖于更大的估计的Hivalines 成年妇女，预防母亲到孩子传播的治疗以及其他估计您的假设 儿童和年轻青少年的艾滋病毒负担之一。 15岁以下的人来自一个来源 - 母亲到孩子传播 - 构造没有性活动， 年轻青少年的零艾滋病毒的刺激性除了行为因素之外 传播受生物医学因素（例如HIV测试率，抗逆转疗法覆盖率）的影响 结构性因素（例如，国家财富，获得教育，医疗保健质量和访问）。 对这些因素的系统研究没有系统地研究，这些因素是关于HIV流行病的轨迹。 流行病的复杂性以及对因素的解释，需要其他数据和分析才能 了解这些因素的相对影响。 对于增强对流行病的驱动因素的理解至关重要，并产生更强大 估计儿童和青少年。 通过三角测量的经验数据源来产生更准确，更全面的估计 小儿艾滋病毒负担，包括生物医学，行为和结构因素如何影响 儿童和青少年的负担是我们的提议，超越了现有工作 曾经估计年轻青少年中新的HIV感染，并将这些结果纳入 交互式可视化平台，以帮助关键利益相关者了解当前和预计的未来负担 不同情况下的儿童和青少年中的艾滋病毒/艾滋病。 目的：（1）合并当前未使用的数据源，以估算母亲到孩子的传播和HIB负担 在儿童中（0-9岁）； 生物医学，行为和某些结构因素对艾滋病毒透射率概率和死亡率的影响 儿童和两个人 2040年，基于当前发病率，患病率和死亡率的趋势以及风险和保护因素的暴露。