Assessing the Impact of Economic Policies on the Use of Pre-Exposure Prophylaxis in the United States

评估经济政策对美国使用暴露前预防的影响

• 批准号: 10698785
• 负责人: Bita Fayaz Farkhad
• 金额: $ 13.48万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2028-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10698785
• 关键词: Acquired Immunodeficiency Syndrome; Affect; Affordable Care Act; Age; American; Area; Artificial Intelligence; Attitude; Award; Behavior; Behavior Control; Behavioral; Big Data; Black race; Caring; Case Management; Computing Methodologies; Cost Sharing; Data; Data Analyses; Data Science; Data Sources; Databases; Economic Policy; Effectiveness; Effectiveness of Interventions; Electronics; Environment; Epidemic; Epidemiology; Equation; Excision; Federal Government; Foundations; Future; Goals; HIV; HIV Infections; Health; Health Policy; Hispanic; Human immunodeficiency virus test; Image; Incidence; Instagram; Intervention; Justice; Knowledge; Latino; Link; Mathematics; Measures; Mediating; Mediator; Medicaid; Mentors; Mentorship; Methodology; Methods; Modeling; National Institute of Allergy and Infectious Disease; Natural experiment; Not Hispanic or Latino; Outcome; Pathway interactions; Pennsylvania; Persons; Pharmaceutical Preparations; Pharmacy facility; Policies; Policy Analysis; Population; Positioning Attribute; Provider; Psychosocial Assessment and Care; Public Health; Records; Regulation; Research; Research Personnel; Research Scientist Award; Role; Science; Social Sciences; Solid; State Government; Surveys; Techniques; Telemedicine; Testing; Text; Training; Twitter; United States; United States National Institutes of Health; Universities; Update; Vulnerable Populations; black men who have sex with men; career; compare effectiveness; comparison intervention; condoms; cost; demographics; design; econometrics; economic impact; effectiveness evaluation; ethnic disparity; experience; health care availability; health disparity; health inequalities; health plan; improved; innovation; longitudinal analysis; longitudinal database; marginalization; men; men who have sex with men; pre-exposure prophylaxis; prior authorization; programs; prospective; racial disparity; sex; skills; social; social health determinants; social media; social stigma; success; theories; transmission process; uptake; Acquired Immunodeficiency Syndrome; Affect; Affordable Care Act; Age; American; Area; Artificial Intelligence; Attitude; Award; Behavior; Behavior Control; Behavioral; Big Data; Black race; Caring; Case Management; Computing Methodologies; Cost Sharing; Data; Data Analyses; Data Science; Data Sources; Databases; Economic Policy; Effectiveness; Effectiveness of Interventions; Electronics; Environment; Epidemic; Epidemiology; Equation; Excision; Federal Government; Foundations; Future; Goals; HIV; HIV Infections; Health; Health Policy; Hispanic; Human immunodeficiency virus test; Image; Incidence; Instagram; Intervention; Justice; Knowledge; Latino; Link; Mathematics; Measures; Mediating; Mediator; Medicaid; Mentors; Mentorship; Methodology; Methods; Modeling; National Institute of Allergy and Infectious Disease; Natural experiment; Not Hispanic or Latino; Outcome; Pathway interactions; Pennsylvania; Persons; Pharmaceutical Preparations; Pharmacy facility; Policies; Policy Analysis; Population; Positioning Attribute; Provider; Psychosocial Assessment and Care; Public Health; Records; Regulation; Research; Research Personnel; Research Scientist Award; Role; Science; Social Sciences; Solid; State Government; Surveys; Techniques; Telemedicine; Testing; Text; Training; Twitter; United States; United States National Institutes of Health; Universities; Update; Vulnerable Populations; black men who have sex with men; career; compare effectiveness; comparison intervention; condoms; cost; demographics; design; econometrics; economic impact; effectiveness evaluation; ethnic disparity; experience; health care availability; health disparity; health inequalities; health plan; improved; innovation; longitudinal analysis; longitudinal database; marginalization; men; men who have sex with men; pre-exposure prophylaxis; prior authorization; programs; prospective; racial disparity; sex; skills; social; social health determinants; social media; social stigma; success; theories; transmission process; uptake

PROJECT SUMMARY Although involve PrEP case changes based, project will policies, secondary impact on condom use and HIV testing. social-behavioral their 2 MSM. PrEP These mathematical policy such recent federal and state policies targeted t o encourage PrEP (pre-exposure prophylaxis) — which (a) enabling pharmacy-based PrEP delivery 1 , (b) leveraging Medicaid program's benefits to promote (i.e., removal of prior authorization, coverage of telemedicine-delivered PrEP, and overage of targeted management) 2 , and (c) mandating zero-cost sharing 3 — have been described as the most significant that have happened with PrEP 4 – , their impact is not well understood. By implementing a theory- multi-level, longitudinal analysis of how public health policies identify policies to efficiently achieve the Ending the HIV Epidemic goals. – 13 Aim 1 will integrate prescription data, surveys, and consumer data to isolate the effects of the policies on PrEP use Aim 2 will expand our longitudinal database to include determinants of PrEP use, including attitudes, norms, and behavioral control, and explore mediating role in the relation between public health policies and PrEP uptake and persistence. Aims 1 and will mode l a) the US population, (b) MSM (men who have sex with men), and (c) Black, Hispanic, and White Aim 3 will f urther examine the effectiveness of the policies studied in Aim 1 by moving from effects on t o modeling effects on HIV transmission among MSM in general and Black, Hispanic, and White MSM. three aims will be achieved through an innovative combination of econometric, big data, tatistical, and methods. First, a difference in differences method will compare intervention areas in which a has been implemented and control areas without the policy while adjusting for unmeasured confounders as differences in culture or demographics. Second, big data analyses c 6 affect PrEP uptake and persistence, this 7 and ( s , will assess psychosocial determinants of PrEP use for different regions and investigate the role of the policies in eliciting behavioral change. Third, of important populations Award these results will inform an agent-based model of HIV transmission that will project the impact the interventions for MSM, taking into account national race/ethnic disparities. Dr. Fayaz-Farkhad has made contributions to understanding the effectiveness of interventions targeted for marginalized and is an accomplished junior researcher with ample experience in the field of HIV. This K01 will extend her trajectory with training in several key areas:(i) HIV epidemiology, (ii) the science of attitudes and behavior, (iii) health inequalities, and (iv) advanced methodological skills. provide whose project cross-cutting Behavioral The proposed K01 will training and mentorship to serve as the foundation for her career as an independent investigator research will serve to improve healthcare access for populations vulnerable to HIV infection. This is well-aligned with NIAID's strategic objectives and directly in line with the Office of AIDS Research areas of Health Disparities to reduce the incidence of HIV in priority populations and utilize and Social Sciences for HIV care.

项目摘要 虽然 涉及 准备 案件 更改 基于， 项目将 政策， 对避孕套使用和艾滋病毒测试的次要影响。 社交行为 他们的 2 MSM。 准备 这些 数学 政策 这样的 最近针对的联邦和州政策鼓励采取预期（预防曝光前） - （a）启用基于药房的准备交付1，（b）利用医疗补助计划的好处来促进 （即，删除事先授权，远程医疗销售的预付款以及目标的过度 管理）2和（c）强制执行零成本共享3-被描述为最重要的 PREP 4发生的事情 - 他们的影响尚不清楚。通过实施理论 - 多层，纵向分析公共卫生政策如何 确定政策有效地实现艾滋病毒流行目标的结局。 - 13 AIM 1将整合 处方数据，调查和消费者数据以隔离政策对准备的影响 AIM 2将扩展我们的纵向数据库，以包括 确定准备使用者，包括与会者，规范和行为控制，并探索 调解公共卫生政策与准备和持久性之间的关系中的作用。目标1和 将模式l a）美国人口，（b）MSM（与男人发生性关系的男人），以及（c）黑人，西班牙裔和白色 AIM 3将通过从对目标的影响转移到AIM 1中研究策略的有效性 对MSM和黑色，西班牙裔和白色MSM的HIV传播的建模影响。 通过经济，大数据，泰式杂志和 方法。首先，差异方法的差异将比较干预领域 在调整未衡量的混杂因素的同时，已经实施并控制了没有政策的领域 作为文化或人口统计学的差异。第二，大数据分析 c 6 影响准备的吸收和持久性，这 7 和 （（ s ，，，， 将评估社会心理 对不同区域的预备使用的决定因素，并研究了政策在引发行为的作用 改变。第三， 的 重要的 人群 奖 这些结果将为基于代理的HIV传播模型提供信息，该模型将投影影响 考虑到国家种族/种族差异，MSM的干预措施。 Fayaz-Farkhad博士做了 理解针对边缘化的干预措施的有效性的贡献 并且是一位经验丰富的初级研究人员，在艾滋病毒领域拥有丰富的经验。这个K01 将在几个关键领域的培训中扩展她的轨迹：（i）艾滋病毒流行病学，（ii） 态度和行为，（iii）健康不平等和（iv）先进的方法论技巧。 提供 谁 项目 横切 行为 拟议的K01将 培训和心态，是她作为独立研究员职业生涯的基础 研究将有助于改善容易受到艾滋病毒感染的人群的医疗保健。这 与NIAID的战略目标保持一致，直接与艾滋病研究办公室一致 健康差异领域，以减少优先人群中的艾滋病毒发病率并利用 和艾滋病毒护理的社会科学。