Diagnosing and preventing HIV infection in adolescents and young adults in the US: clinical impact and cost-effectiveness

诊断和预防美国青少年和年轻人的艾滋病毒感染：临床影响和成本效益

基本信息

批准号：
9756435
负责人：
Anne Neilan
金额：
$ 17.2万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-07 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9756435
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address Adherence Adolescent Medicine Adolescent and Young Adult Adult Affect Age Area Behavior Behavioral Sciences Caring Centers for Disease Control and Prevention (U.S.)Chronic Disease Clinical Clinical Investigator Clinical Research Clinical Trials Communicable Diseases Complex Computer Simulation Continuity of Patient Care Cost Effectiveness Analysis Data Analyses Derivation procedure Development Diagnosis Disease model Effectiveness Epidemic Epidemiology Fellowship Foundations Future General Hospitals Goals HIV HIV Infections HIV diagnosis HIV-infected adolescents Health Health Care Costs Health Policy Individual Infection Intervention K-Series Research Career Programs Massachusetts Medicine Mentors Mentorship Methodology Methods Modality Modeling NIH Office of AIDS Research National Institute of Child Health and Human Development Observational Study Outcome Pathway interactions Pattern Patterns of Care Pediatrics Performance Pharmaceutical Preparations Physicians Policies Population Positioning Attribute Prevalence Prevention Prevention approach Public Health Publishing Research Research Personnel Research Priority Research Support Resources Risk Scientist Service delivery model Services Structural Models Structure Study models Techniques Time Toxic effect Training United States National Institutes of Health Viral Vulnerable Populations Work Youth aged antiretroviral therapy base care seeking career career development clinical decision-making cost effectiveness design disorder prevention economic outcome effective intervention experience health care delivery health economics high risk improved improved outcome innovation investigator training medication compliance model development models and simulation multidisciplinary novel novel strategies pre-exposure prophylaxis prevent prevention service research and development screening transmission process treatment adherence vulnerable adolescent young men who have sex with men

项目摘要

Project Summary/Abstract New HIV infections among youth ages 13-24 comprise 22% of all new HIV infections in the US. More than 60,000 adolescents and young adults (AYA) are already living with HIV in the US, and new infections contribute substantially to HIV transmission. The HIV epidemic among US AYA demands new approaches to HIV diagnosis and prevention, with consideration of the challenges of health care delivery and research among AYA living with and at risk of acquiring HIV. Computer simulation health-policy models can add substantial value to clinical trials and observational studies by projecting outcomes beyond the time horizon of clinical studies. This is particularly important for AYA, in whom the effects of HIV infection and treatment may not manifest for many years. This mentored clinical scientist research career development award will allow the recipient, an infectious diseases physician at Massachusetts General Hospital, to develop a research career using modeling methods and cost-effectiveness analysis to evaluate current critical questions in HIV prevention and screening in US AYA. Reducing incident HIV infections, improving HIV screening, optimizing HIV pre-exposure prophylaxis services, and assessing HIV pre-exposure prophylaxis effectiveness are high- priority areas for the NIH Office of AIDS Research (2018 Goals) and NICHD (2017 New Research Priorities). Collaborating with national studies of AYA affected by HIV, this project will develop a new, comprehensive health policy model of HIV disease prevention, diagnosis and treatment in AYA. The model will reflect age- and developmentally-specific AYA patterns of care-seeking behaviors, including engagment in care and adherence to medications. The model will be used to evaluate the short- and long-term clinical outcomes and healthcare costs associated with the screening and prevention of HIV in US AYA, focusing on a key sub-population, young men who have sex with men.This work will build a foundation for future analyses of the delivery of HIV pre-exposure prophylaxis and other emerging screening, treatment and prevention modalities. This mentored research will be accompanied by relevant training in model development, derivation of trial-based model inputs, and performance of policy-relevant analyses. This research and career development training provide the recipient with a pathway to an independent career as a clinical investigator, focused on using modeling methodology to optimize care for adolescents and young adults affected by HIV.

项目摘要/摘要 13-24岁青年中的新艾滋病毒感染占美国所有新艾滋病毒感染的22％。多于 60,000名青少年和年轻人（AYA）已经在美国患有艾滋病毒和新感染对艾滋病毒的传播做出了基本贡献。我们中间的艾滋病毒流行我们需要新的方法 HIV诊断和预防，考虑到医疗保健提供和研究的挑战 Aya与获取艾滋病毒的风险同在。计算机模拟健康政策模型可以增加大量通过预测超出临床时间范围的结果，对临床试验和观察性研究的价值研究。这对于AYA尤其重要，其中HIV感染和治疗的影响可能不会表现多年。这个受过指导的临床科学家研究职业发展奖将使接受者是马萨诸塞州综合医院的传染病医师，以发展研究生涯使用建模方法和成本效益分析来评估当前的艾滋病毒关键问题预防和筛选美国。减少事件HIV感染，改善HIV筛查，优化 HIV暴露前的预防服务，评估HIV暴露前预防有效性是高的 NIH艾滋病研究办公室（2018年目标）和NICHD（2017年新研究优先事项）的优先领域。该项目与受艾滋病毒影响的AYA的国家研究合作，将开发一个新的，全面的 AYA中的HIV疾病预防，诊断和治疗的卫生政策模型。该模型将反映年龄和寻求护理行为的开发特定的AYA模式，包括订婚和遵守进行药物。该模型将用于评估短期和长期临床结果和医疗保健与美国AYA筛查和预防HIV相关的成本，重点是关键的子人群，与男人发生性关系的年轻人。这项工作将为未来分析艾滋病毒的分析奠定基础暴露前预防和其他新出现的筛查，治疗和预防方式。这是指导的研究将伴随模型开发中的相关培训，基于试验模型的推导输入和与政策相关的分析的绩效。这项研究和职业发展培训提供具有临床研究者独立职业途径的接收者，专注于使用建模优化对受艾滋病毒影响的青少年和年轻人的护理的方法。