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 终结艾滋病毒流行 (EHE) 倡议大胆旨在将高负担地区的艾滋病毒发病率降低 90% 到 2030 年，但在衡量发病率以确定优先人群以及了解如何最好地采取措施方面仍然存在挑战 迄今为止，基于艾滋病毒分子监测的干预措施尚未与艾滋病毒相关联。 即（极少数例外）针对相关个人的公共卫生努力。 艾滋病毒传播迅速增长的集群尚未被证明可以减少新发艾滋病毒感染的数量 或在提供这些服务的地区或群体中受到病毒抑制的人数比例。 没有现有的资源分配模型可以根据当地分子和艾滋病毒项目数据来指导 确定如何最好地分配与 EHE 目标相关的资源。 “通过系统动力学提高资源公平性 (LAC ASPIRE)”团队将使用 i) 先进的系统动力学 确定传播率最高人群的发病率方法和前瞻性措施 洛杉矶县 (LAC) 和 ii) 优化公共卫生计划资源分配的经济模型 ASPIRE 团队是由以下研究人员组成的合作伙伴关系，以实现 EHE 和其他利益相关者的目标。 一些学术大学和 LAC HIV 和 STD 分析部门 (DHSP) 将使用编码。 拟议的研究将由 LAC DHSP 提供去识别化的 HIV 监测数据和项目数据。 确定传播率最高的 LAC 人群并表示为我们将使用的优先人群。 建立经济模型来制定优化预防资源分配的战略，以 i) 减少艾滋病毒 发病率，ii) 改善与艾滋病毒相关的健康结果，以及 iii) 改善人群之间的公平性。 利益相关者——定义为 1) LAC DHSP 人员，2) 直接或间接参与 HIV 管理的人员 拉丁美洲和加勒比地区的计划，以及 3) 艾滋病毒感染者 (PWH) 和其他主要受影响人群——提供指导 区域可接受且最有可能实现的人口和资源优先战略 EHE 目标。 总体研究目标是制定一个流程来指导与艾滋病毒项目分配相关的决策 公共卫生部门根据区域计划和具体项目的传输数据提供资源。 目标包括： 目标 1（确定）。确定艾滋病毒预防工作最优先考虑的人群（这些人群）。 数据将为目标 2 中使用的流行病模型提供信息（分配）；开发用户友好的动态。 传输模型将预测替代策略的影响，以优化资源配置 拉丁美洲和加勒比地区艾滋病毒预防计划（这些数据将预测健康结果和成本效益）和目标 3； （参与）。让主要利益相关者参与制定指导项目成果和建设能力的流程。 LAC 卫生部门采用目标 1 和目标 2 方法进行数据分析。