Localized economic modeling to support implementation of the Ending the HIV Epidemic initiative

支持实施“终结艾滋病毒流行”倡议的本地化经济模型

基本信息

批准号：
10472012
负责人：
Bohdan Nosyk
金额：
$ 55.08万
依托单位：
SIMON FRASER UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-03-01 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10472012
关键词：
AIDS prevention AIDS/HIV problem Accounting Address Advisory Committees Black race COVID-19 COVID-19 pandemic Centers for Disease Control and Prevention (U.S.)Cities Collaborations Collection Communication Communities Community Health Cost Effectiveness Analysis Country County Custom Data Decision Making Development Diagnosis Disease Outbreaks Early Diagnosis Economic Models Effectiveness Elements Ensure Epidemic Epidemiology Evidence based intervention Funding Geography Goals HIV HIV Infections HIV diagnosis Health Health Benefit Health Services Accessibility Health system Human Resources Infection Infrastructure Intervention Justice Latinx Laws Lead Methodology Modeling Outcome Output Persons Phase Policies Prevention Public Health Public Health Schools Puerto Rico Research Research Personnel Resources Rural Services Sexual Partners Testing Time United States United States Health Resources and Services Administration Universities Update Washington Work base care systems cost effectiveness dashboard disparity reduction dissemination science economic evaluation evidence base flexibility health care availability health care disparity health difference health economics health equity promotion implementation process implementation science implementation strategy improved innovation knowledge translation models and simulation novel strategies pre-exposure prophylaxis prevent prevention service racial and ethnic rapid detection response scale up service delivery service intervention service programs tool translational approach transmission process treatment services

项目摘要

Localized economic modeling to support implementation of Whe µEQdiQg Whe HIV ESidePic iQ APeUica¶ initiative Rather than a homogeneous national epidemic, the HIV epidemic in the United States is a collection of diverse local microepidemics concentrated primarily in the South, hotspot counties, and large urban centers, with fundamental differences in health system infrastructure, funding and HIV-related laws and policies across jurisdictions. Recognizing these facts, the US OaXQcKed WKe aPbLWLRXV µEQdLQJ WKe HIV ESLdePLc (EHE) LQLWLaWLYe LQ FebUXaU\ 2019. TKe SOaQ caOOed IRU an initial focus on 48 counties accounting for more than 50% of all new HIV diagnoses plus Washington, DC, San Juan, Puerto Rico and seven states with substantial rural burden to reduce new infections by 75% within 5 years and by 90% within 10 years. These goals are now challenged by the onset of the global COVID-19 pandemic, which may have severe consequences for people living with HIV and on HIV microepidemics across the US. Further, with widespread civil protest demanding racial justice across the US, a value-based approach that accounts for the pervasive racial/ethnic inequities in healthcare access and explicating key elements of the implementation process needed to reach optimal levels of service delivery are now more critical than ever in reaching the ambitious targets of the EHE initiative. We propose to renew our previously-funded R01 JUaQW eQWLWOed ³Localized economic modeling for the treatment and prevention of HIV/AIDS´ (R01-DA0041747). In this competitive renewal application, we propose an integrated set of aims, executed in parallel, with the goal of establishing a decision-making platform that considers all strategies relevant to communities and decision-makers in EHE-targeted jurisdictions, acknowledges COVID-19-related disruptions in access to services, and integrates new evidence as it emerges. We propose to expand our focal set of evidence-based interventions to Diagnose, Treat and Prevent HIV infection to also consider the potential impact of the Respond pillar of the EHE initiative; to work with local communities and public health officials to refine and tailor our analysis to local needs and constraints; and to extend our geographic focus to cover each of the jurisdictions targeted in phase 1 of the EHE initiative, applying a novel approach, distributional cost-effectiveness analysis, to simultaneously maximize the impact of local HIV responses and reduce racial/ethnic inequities in healthcare access.

支持实施 Whe µEQdiQg Whe HIV ESidePic iQ APeUica¶ 计划的本地化经济模型美国的艾滋病毒流行不是单一的全国性流行病，而是不同地方的流行病的集合。微疫情主要集中在南方、热点县和大城市中心，存在根本差异认识到这些事实，各司法管辖区的卫生系统基础设施、资金和艾滋病毒相关法律和政策。 US OaXQcked WKe aPbLWLRXV µEQdLQJ WKe HIV ESLdePLc (EHE) LQLWLaWLYe LQ FebUXaU\ 2019。TKe SOaQ caOOed IRU 初始重点关注 48 个县，占所有新艾滋病毒诊断的 50% 以上，以及华盛顿特区、圣胡安、波多黎各农村负担沉重的州在 5 年内将 7 种新感染病例减少 75%，在 10 年内减少 90%。这些目标现在受到全球 COVID-19 大流行的挑战，这可能会对此外，美国各地的艾滋病毒感染者和艾滋病毒微流行病患者也面临着广泛的公民抗议，要求种族歧视。美国各地的正义，一种基于价值的方法，解释了医疗保健获取中普遍存在的种族/民族不平等并解释实现最佳服务交付水平所需的实施过程的关键要素现在更加对于实现 EHE 倡议的宏伟目标比以往任何时候都至关重要。我们建议更新之前资助的 R01 JUaQW eQWLWOed ³治疗的本地化经济模型和艾滋病毒/艾滋病的预防（R01-DA0041747）在这个竞争性的更新申请中，我们提出了一套综合的方案。并行执行的目标是建立一个考虑所有相关战略的决策平台 EHE 目标管辖区的社区和决策者承认与 COVID-19 相关的获取服务中断我们建议将基于证据的干预措施的重点范围扩展到以下领域：诊断、治疗和预防 HIV 感染，同时考虑 EHE 倡议的响应支柱的潜在影响；与当地社区和公共卫生官员合作，根据当地需求和限制完善和调整我们的分析；并将我们的地理重点扩展到 EHE 计划第一阶段目标的每个司法管辖区，应用新方法，分配成本效益分析，同时最大限度地发挥当地艾滋病毒应对措施的影响并减少医疗保健获取方面的种族/民族不平等。