Miami Dade County ASsessment of Phylogenetics to Improve Resource Equity: MD ASPIRE

迈阿密戴德县系统发生学评估以改善资源公平：MD ASPIRE

• 批准号: 10460007
• 负责人: SUSAN JANET LITTLE
• 金额: $ 98.69万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-07-01 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10460007
• 关键词: AIDS prevention; Acute; Affect; Area; Blood specimen; Code; Consensus; County; Data; Data Analyses; Decision Making; Economic Models; Economics; Epidemic; Evaluation; Feedback; Future; Geography; Goals; HIV; HIV Infections; HIV/STD; Health; Health Personnel; Human Resources; Incidence; Individual; Infection; Infrastructure; Intervention; Laboratories; Link; Los Angeles; Measures; Methods; Modeling; Molecular; Outcome; Pathway Analysis; Persons; Population; Prevalence; Prevention; Prevention program; Process; Program Evaluation; Public Health; Reporting; Research Personnel; Resource Allocation; Resources; Risk; Services; Surveillance Program; Testing; Universities; Viral; base; cost; cost effectiveness; data exchange; efficacy outcomes; evidence base; health equity; implementation strategy; improved; population based; preventive intervention; programs; prospective; secondary analysis; surveillance data; tool; transmission process; user-friendly

ABSTRACT The Ending the HIV Epidemic (EHE) Initiative boldly aims to reduce HIV incidence in high burden areas by 90% by 2030, yet challenges remain in measuring incidence to identify priority populations and knowing how to best allocate local resources. To date, HIV molecular surveillance-based interventions have not been linked to a reduction in HIV incidence. That is (with rare exception), public health efforts directed to individuals associated with rapidly growing HIV transmission clusters have not been shown to reduce the number of new HIV infections or the proportion of people virally suppressed in the regions or groups where these services were delivered. There are no existing resource allocation models that are informed by local molecular and HIV program data to determine how to best allocate resources relevant to EHE targets. The “Los Angeles County ASsessment of Phylodynamics to Improve Resource Equity (LAC ASPIRE)” team will use i) advanced phylodynamic approaches and prospective measures of incidence to identify populations with the highest transmission rates in Los Angeles County (LAC) and ii) economic modeling to optimize allocation of public health program resources to achieve EHE and other stakeholder targets. The ASPIRE team is a partnership between investigators at several academic universities and the LAC Division of HIV and STD Programs (DHSP). Analyses will use coded and de-identified HIV surveillance data and program data provided by the LAC DHSP. The proposed study will identify LAC populations with the highest transmission rates and denote as priority populations. We will use economic modeling to develop strategies that optimize the allocation of prevention resources to i) reduce HIV incidence, ii) improve HIV-related health outcomes, and iii) improve equity across populations. We will engage stakeholders—defined as 1) LAC DHSP personnel, 2) those directly or indirectly involved in administering HIV Programs in LAC, and 3) persons with HIV (PWH) and other key affected populations—to provide guidance on population and resource prioritization strategies that are both regionally acceptable and most likely to achieve EHE targets. The overall study objective is to develop a process to guide decision-making related to allocation of HIV program resources by public health departments informed by regional program and transmission data. Project specific aims include: Aim 1 (IDENTIFY). Identify populations that are the highest priority for HIV prevention efforts (these data will inform the epidemic model used in Aim 2); Aim 2 (ALLOCATE). Develop a user-friendly dynamic transmission model that will project the impact of alternative strategies for the optimal allocation of resources to LAC HIV prevention programs (these data will project health outcomes and cost-effectiveness); and Aim 3 (ENGAGE). Engage key stakeholders to develop a process to guide project outcomes and build capacity at the LAC Health Department for data analysis that incorporates Aim 1 and 2 methods.

抽象的 艾滋病毒流行病（EHE）倡议的结局大胆旨在将高负担地区的艾滋病毒发病率降低90％ 到2030年，在衡量事件中仍然存在挑战，以确定优先人群并知道如何做到最好 分配本地资源。迄今为止，基于HIV分子监测的干预措施尚未与 减少艾滋病毒事件。也就是说（极少数例外），公共卫生努力针对相关的个人 尚未证明随着迅速增长的HIV传播簇减少新的HIV感染的数量 或在交付这些服务的地区或群体中实际上被压制的人的比例。 没有现有的资源分配模型可以通过本地分子和艾滋病毒计划数据告知 确定如何最好地分配与EHE目标相关的资源。 “洛杉矶县评估 系统动力学以提高资源权益（LAC ASPIRE）”团队将使用i）高级系统动力学 识别传输率最高的人口的方法和前瞻性措施 在洛杉矶县（LAC）和II）经济建模以优化公共卫生计划资源的分配 实现EHE和其他利益相关者目标。 Aspire团队是调查人员的合作伙伴 几所学术大学以及艾滋病毒和性病计划（DHSP）的LAC分部。分析将使用编码 LAC DHSP提供的鉴定的HIV监视数据和程序数据。拟议的研究将 确定传输速率最高的LAC种群，并表示为优先人群。我们将使用 经济建模以制定优化预防资源分配给i）减少艾滋病毒的策略 发病率，ii）改善与HIV相关的健康结果，iii）改善人群之间的平等。我们将参与 利益相关者 - 定义为1）LAC DHSP人员，2）直接或间接参与艾滋病毒的人 LAC和3）患有艾滋病毒（PWH）和其他受主要影响人群的人的计划，以提供指导 人口和资源优先级策略在区域上都可以接受，并且最有可能实现 目标。 总体研究目标是制定一个过程，以指导与艾滋病毒计划分配有关的决策 由区域计划和传输数据告知的公共卫生部门的资源。特定项目 目的包括：目标1（识别）。确定预防艾滋病毒预防工作最高优先事项的人群（这些 数据将为AIM 2中使用的流行模型提供信息；目标2（分配）。开发一个用户友好的动态 传输模型将投影替代策略对资源最佳分配的影响 LAC HIV预防计划（这些数据将预测健康成果和成本效益）；和目标3 （从事）。吸引主要利益相关者开发一个过程，以指导项目成果并在 LAC卫生部门的数据分析，其中包含AIM 1和2方法。