Evaluating the Link between HIV Prevention and Treatment

评估艾滋病毒预防和治疗之间的联系

• 批准号: 6756397
• 负责人: A. DAVID PALTIEL
• 金额: $ 44.34万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2005-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6756397
• 关键词: AIDS /HIV test; AIDS education /prevention; AIDS therapy; HIV infections; behavioral /social science research tag; clinical research; comprehensive medical planning; computer simulation; counseling; disease /disorder proneness /risk; epidemiology; health care model; health care policy; health care service evaluation; health economics; health services research tag; high risk behavior /lifestyle; human data; mass screening; medically underserved population; public health

DESCRIPTION (provided by applicant): Of the estimated 800,000 to 900,000 Americans who are currently infected with HIV, it is believed that as many as 275,000 remain unaware of their infection and are therefore without access to life-prolonging care or counseling that could prevent the further spread of the virus. This sobering fact suggests that it is time to reconsider the public health approach to HIV counseling, testing, and referral (HIV CTR) in the United States and to quantify the consequences of failing to provide adequate screening, treatment, and prevention. In the last seven years, our research group has published eighteen peer-reviewed policy evaluations using a computer simulation model of the clinical management and economics of HIV. Our findings have had a direct impact on HIV patient care decisions in the United States. We now propose to expand our model in order to address questions of design and priority setting in HIV CTR. We have two specific aims: (1) we will link our existing disease simulation to a new "screening/intake" model that can portray a broad spectrum of at-risk target populations, clinical settings, and testing/counseling protocols. We will codify the various steps that lead from detection of HIV, through treatment and counseling, to changes in viral infectivity, risky behavior, and disease transmission. We will assemble the most up-to-date clinical, epidemiological, economic, and behavioral data within a single, integrated framework. This will create the first comprehensive, model-based tool for the evaluation of HIV counseling, testing, and referral. (2) We will conduct and disseminate three policy evaluations assessing the impact of expanded HIV CTR services. a) We will evaluate the clinical and economic effects of conformity with the CDC's recently promulgated draft Revised Guidelines for HIV Counseling, Testing, and Referral. b) We will conduct an extensive assessment of alternative CTR intervention designs and provide practical guidance to decision makers wishing to tailor program attributes to population-, and setting-specific needs. c) We will perform the first formal exploration of the transmission benefits and risks of expanded HIV CTR in the HAART era. The investigators have a proven record of producing and disseminating findings that have helped to set priorities in HIV patient care, clinical trial design, and guideline development. Our aim, in the present proposal, is to exert an equally profound impact on priority setting in HIV testing and prevention.

描述（由申请人提供）：估计 800,000 至 900,000 据信，目前感染艾滋病毒的美国人有多达 275,000 人仍然不知道自己受到感染，因此无法获得 可以防止疾病进一步传播的延长生命的护理或咨询 病毒。这一发人深省的事实表明，是时候重新考虑公众了 HIV 咨询、检测和转诊 (HIV CTR) 的健康方法 美国并量化未能提供足够的后果的后果 筛查、治疗和预防。在过去的七年里，我们的研究 该小组已使用计算机发布了十八项经过同行评审的政策评估 HIV临床管理和经济学的模拟模型。我们的发现 对美国艾滋病毒患者的护理决策产生了直接影响。我们 现在建议扩展我们的模型以解决设计和 HIV CTR 的优先级设定。我们有两个具体目标：（1）我们将我们的 现有的疾病模拟到新的“筛查/摄入”模型可以描绘 广泛的高危目标人群、临床环境和 测试/咨询协议。我们将把由此产生的各个步骤编成法典 通过治疗和咨询检测艾滋病毒，以了解病毒的变化 传染性、危险行为和疾病传播。我们将组装 最新的临床、流行病学、经济和行为数据 一个单一的、集成的框架。这将创建第一个综合性、 用于评估艾滋病毒咨询、检测和转诊的模型工具。 (2) 我们将开展并传播三项政策评估，评估 扩大艾滋病毒 CTR 服务的影响。 a) 我们将评估临床和 符合疾病预防控制中心最近颁布的草案的经济影响 修订后的艾滋病毒咨询、检测和转诊指南。 b) 我们会 对替代 CTR 干预设计进行广泛评估 为希望定制计划的决策者提供实用指导 归因于人口和环境的特定需求。 c) 我们将执行 首次正式探讨艾滋病毒扩大传播的益处和风险 HAART时代的CTR。调查人员有生产和 传播有助于确定艾滋病毒患者护理优先事项的研究结果， 临床试验设计和指南制定。我们的目标，在当下 提案的目的是对艾滋病毒优先事项的确定产生同样深远的影响 检测和预防。