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

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.

项目概要 虽然 涉及 暴露前预防 案件 变化 基于， 项目将 政策、 对安全套使用和艾滋病毒检测的次要影响。 社会行为 他们的 2 男同性恋者。 暴露前预防 这些 数学的 政策 这样的 最近的联邦和州政策旨在鼓励 PrEP（暴露前预防）—— (a) 实现基于药房的 PrEP 交付 1，(b) 利用医疗补助计划的优势来促进 （即取消事先授权、远程医疗提供的 PrEP 的覆盖范围以及目标药物的过量） 管理）2 和 (c) 强制实施零成本共享 3 — 被认为是最重要的 PrEP 4 所发生的情况 - ，其影响尚未得到很好的理解。 对公共卫生政策如何进行多层次、纵向分析 – 13 个目标 1 将整合 处方数据、调查和消费者数据，以隔离政策对 PrEP 使用的影响 目标 2 将扩展我们的纵向数据库以包括 PrEP 使用的决定因素，包括态度、规范和行为控制，并探索 公共卫生政策与 PrEP 的采用和坚持之间的中介作用。 将模拟 l a) 美国人口，(b) MSM（男男性行为者），以及 (c) 黑人、西班牙裔和白人 目标 3 将进一步检验目标 1 中研究的政策的有效性 模拟一般 MSM 以及黑人、西班牙裔和白人 MSM 中 HIV 传播的影响。 通过计量经济学、大数据、统计和统计的创新结合来实现三个目标 首先，差异法将比较干预领域。 已实施并控制没有政策的领域，同时调整未测量的混杂因素 其次，大数据分析。 c 6 影响 PrEP 的吸收和持久性，这 7 和 （ s , 将评估社会心理 不同地区 PrEP 使用的决定因素，并调查政策在引发行为方面的作用 第三， 的 重要的 人口 奖 这些结果将为基于代理的艾滋病毒传播模型提供信息，该模型将预测其影响 Fayaz-Farkhad 博士考虑到民族种族/民族差异，对 MSM 采取了干预措施。 有助于了解针对边缘化群体的干预措施的有效性 K01 是一位在 HIV 领域拥有丰富经验的颇有成就的初级研究员。 将通过在几个关键领域的培训来扩展她的发展轨迹：(i) 艾滋病毒流行病学，(ii) 艾滋病毒流行病学 态度和行为，(iii) 健康不平等，以及 (iv) 先进的方法技能。 提供 谁 项目 横切 行为方面 拟议的K01将 培训和指导为她作为独立调查员的职业生涯奠定了基础 研究将有助于改善易受艾滋病毒感染的人群的医疗保健服务。 与 NIAID 的战略目标高度一致，并与艾滋病研究办公室直接保持一致 减少重点人群的艾滋病毒发病率并利用 和艾滋病毒护理的社会科学。