Improving the Public Health Impact of HIV Testing in Highly Endemic Regions

改善高流行地区艾滋病毒检测对公共卫生的影响

• 批准号: 8112448
• 负责人: Eran Bendavid
• 金额: $ 13.05万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-15 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8112448
• 关键词: AIDS prevention; Adopted; Affect; Africa; Africa South of the Sahara; Anti-Retroviral Agents; Area; Attention; Birds; Caring; Cause of Death; Cessation of life; Cost Effectiveness Analysis; Costs and Benefits; Counseling; Country; Data; Data Sources; Development; Early Diagnosis; Eating; Effectiveness; Enrollment; Environment; Epidemic; Epidemiology; Evaluation; Funding; Future; Goals; Guidelines; HIV; Health; Health care facility; Highly Active Antiretroviral Therapy; Human Rights; Human immunodeficiency virus test; Incidence; Individual; Infection; Informed Consent; Liberia; Mentors; Modeling; Outcome; Output; Partner in relationship; Policies; Policy Maker; Policy Making; Population; Prevalence; Prevention; Prevention program; Preventive; Preventive Intervention; Principal Investigator; Process; Provider; Public Health; Qi; Recommendation; Research; Research Personnel; Resources; Rest; Risk Behaviors; Screening procedure; Services; Sexual Transmission; Shapes; Testing; Training; Training Activity; United States National Institutes of Health; Woman; World Health Organization; antiretroviral therapy; career; comparative; cost effectiveness; experience; falls; global health; improved; infectious disease model; men; population based; prevent; programs; scale up; seal; treatment program

DESCRIPTION (provided by applicant): HIV is the leading cause of death in Africa, but only a small portion of the population is aware of their serostatus. Early diagnosis of HIV is essential for treatment of infected individuals as well as for prevention of future infections. HIV testing strategies change the prospects for infected individuals, and shape the course of the epidemic by improving survival of treated individuals and possibly changing HIV risk behaviors. As a result, the World Health Organization recently recommended opt-out testing in highly endemic regions, given the appropriate environment. The proposed research plan will evaluate the relationship between testing and risk behaviors, the epidemiologic implications of different testing strategies, and the cost- effectiveness in sub-Saharan Africa. The revised submission includes a broader geographical focus, additional training activities, stronger institutional support, and a narrowed scope for 2 aims. The project has the following specific aims: 1. Review the evidence on the relationship between HIV counseling and testing and risk behaviors related to sexual transmission of HIV in sub-Saharan Africa; 2. Assess how different testing strategies affect HIV epidemic outcomes in sub-Saharan Africa including prevalence, incidence, infections averted, and HIV-related deaths; 3. Evaluate the effectiveness and cost-effectiveness of different HIV testing strategies in sub- Saharan Africa; 4. Understand how policy makers use models and explore the ways in which models of HIV testing can provide useful inputs to the policy making process. I will evaluate the following HIV testing strategies: voluntary counseling and testing (VCT), scaled up VCT, provider-initiated counseling and testing, provider-initiated testing with limited counseling, and population-based screening. I will evaluate all strategies with limited and full availability of antiretroviral therapy. I am mentored by the PI and co-PI of experienced NIH-funded investigators with 15+ years of experience with HIV policy modeling. It is a product of my personal research objectives and training in infectious disease modeling, cost-effectiveness analysis, and global health. Support for this project will promote informed public health decisions for HIV testing in highly endemic regions, and will prepare me for a research career evaluating HIV treatment and prevention interventions.

描述（由申请人提供）：艾滋病毒是非洲死亡的主要原因，但只有一小部分人知道自己的血清状况。艾滋病毒的早期诊断对于感染者的治疗以及预防未来的感染至关重要。 HIV 检测策略改变了感染者的前景，并通过提高治疗者的生存率和可能改变 HIV 危险行为来塑造流行病的进程。因此，世界卫生组织最近建议在适当的环境下，在高流行地区选择退出检测。拟议的研究计划将评估检测与风险行为之间的关系、不同检测策略的流行病学影响以及撒哈拉以南非洲的成本效益。修订后的提交内容包括更广泛的地理重点、额外的培训活动、更强有力的机构支持以及缩小的 2 个目标范围。该项目有以下具体目标： 1. 审查关于艾滋病毒咨询和检测与撒哈拉以南非洲地区艾滋病毒性传播相关风险行为之间关系的证据； 2. 评估不同的检测策略如何影响撒哈拉以南非洲的艾滋病毒流行结果，包括流行率、发病率、避免的感染和艾滋病毒相关死亡； 3. 评估撒哈拉以南非洲不同艾滋病毒检测策略的有效性和成本效益； 4. 了解政策制定者如何使用模型，并探索艾滋病毒检测模型如何为政策制定过程提供有用的投入。 我将评估以下 HIV 检测策略：自愿咨询和检测 (VCT)、扩大 VCT、提供者发起的咨询和检测、提供者发起的有限咨询检测以及基于人群的筛查。我将评估所有策略，并提供有限且全面的抗逆转录病毒治疗。我接受 PI 和联合 PI 的指导，他们是 NIH 资助的经验丰富的研究人员，他们在艾滋病毒政策建模方面拥有 15 年以上的经验。它是我个人研究目标以及传染病建模、成本效益分析和全球健康方面培训的产物。对这个项目的支持将促进在高流行地区进行艾滋病毒检测的知情公共卫生决策，并使我为评估艾滋病毒治疗和预防干预措施的研究生涯做好准备。