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: 7928864
• 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/7928864
• 关键词: AIDS prevention; Adopted; Affect; Africa; Africa South of the Sahara; Anti-Retroviral Agents; Area; Attention; Caring; Cause of Death; Cessation of life; Cost Effectiveness Analysis; Costs and Benefits; Counseling; Country; Data; Data Sources; Development; Early Diagnosis; Effectiveness; Enrollment; Environment; Epidemic; Epidemiology; Evaluation; Funding; Future; Goals; Guidelines; HIV; Health; Health care facility; Human Rights; Human immunodeficiency virus test; Incidence; Individual; Infection; Informed Consent; Liberia; Male Circumcision; 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; Recommendation; Research; Research Personnel; Resources; Risk Behaviors; Screening procedure; Services; Sexual Transmission; Shapes; Testing; Training; Training Activity; 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

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他们的血清。艾滋病毒的早期诊断对于治疗感染者以及预防未来感染至关重要。艾滋病毒测试策略改变了感染者的前景，并通过改善治疗个体的生存以及可能改变艾滋病毒风险行为的生存来塑造流行病的进程。结果，考虑到适当的环境，世界卫生组织最近建议在高流行地区进行退出测试。拟议的研究计划将评估测试和风险行为之间的关系，不同测试策略的流行病学含义以及撒哈拉以南非洲的成本效益。修订后的提交包括更广泛的地理重点，其他培训活动，更强的机构支持以及针对2个目标的范围狭窄的范围。该项目具有以下特定目标： 1。回顾有关艾滋病毒咨询与检测与艾滋病毒性传播艾滋病毒性传播艾滋病毒在撒哈拉以南非洲的关系之间关系的证据； 2。评估不同的测试策略如何影响撒哈拉以南非洲的艾滋病毒流行结果，包括患病率，发病率，避免感染和与HIV相关的死亡； 3。评估撒哈拉以南非洲不同艾滋病毒测试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测试模型可以为政策制定过程提供有用的输入的方式。 我将评估以下艾滋病毒测试策略：自愿咨询和测试（VCT），扩大VCT，提供者发起的咨询和测试，提供者发起的测试有限，以及基于人群的筛查。我将通过有限且充分利用抗逆转录病毒疗法来评估所有策略。我受到经验丰富的NIH资助的研究人员的PI和Co-Pi的指导，拥有15年以上的HIV政策建模经验。它是我个人研究目标和传染病建模，成本效益分析和全球健康的培训的产物。对该项目的支持将促进高度流行地区的艾滋病毒测试的知情公共卫生决策，并为我的研究职业做好评估评估艾滋病毒治疗和预防干预措施的准备。