NIAAA PA-07-028 calls for studies to identify and model """"""""the impact of alcohol consumption patterns on the spread of HIV infection and associated opportunistic infections over time"""""""" and """"""""the prevention of HIV risk behaviors related to alcohol."""""""" In addition, NIAAA research objectives are increasingly targeting resource- poor settings because of their disproportionate burden of disease. To address these priorities, we aim to create a computer simulation of the HIV pandemic that can evaluate the benefit and value of NIAAA-funded interventions in Sub-Saharan Africa. To ensure that this model reflects the clinical realities of Sub-Saharan Africa as well as the particular features of the alcohol interventions under study, we have assembled a multidisciplinary team of modelers, alcohol experts, HIV experts, statisticians, and epidemiologists;including two PIs of the NIAAA-funded alcohol interventions that are under study. Virtually all of the study team members have extensive experience with clinical care or research in Sub-Saharan Africa. We will use the NIAID-funded, 34,000-patient, International Epidemiologic Databases to Evaluate AIDS (IeDEA) cohort to ensure that the simulation has good predictive validity, and we will design the simulation to represent important social features of HIV transmission in Sub-Saharan Africa (e.g., high prevalence of sexually transmitted infections, social network characteristics, etc). After constructing the simulation and ascertaining that it can predict individual- level and population-level Sub-Saharan outcomes, we will use the simulation to investigate whether NIAAA- funded interventions (1) lead to clinically significant benefits, (2) deliver greater value than WHO guidelines, and (3) deliver greater value than current care. Modeling is a method that is particularly well suited to assess the value of NIAAA-funded Sub-Saharan interventions because clinical trials will only provide short-term behavioral data, and comparing their benefit and value on a """"""""level playing field"""""""" requires estimation of longer- term clinical outcomes. The National Institute of Alcoholism and Alcohol Abuse is studying many ways to decrease alcohol abuse and unprotected sex in regions of the world where HIV transmission risk is the highest. However, resources are very limited and we do not know which of these methods deliver the greatest value. This study aims to use well-tested computer simulation methods to help us assess and compare the value of different methods for preventing HIV transmission, with a focus on methods that specifically target alcohol abuse.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
7R01AA017385-03
Application #
7676805
Study Section
Behavioral and Social Consequences of HIV/AIDS Study Section (BSCH)
Program Officer
Bryant, Kendall
Project Start
2007-09-30
Project End
2012-08-31
Budget Start
2009-09-01
Budget End
2010-08-31
Support Year
3
Fiscal Year
2009
Total Cost
$540,159
Indirect Cost
Name
New York University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
121911077
City
New York
State
NY
Country
United States
Zip Code
10016
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Kessler, Jason; Nucifora, Kimberly; Li, Lingfeng et al. (2015) Impact and Cost-Effectiveness of Hypothetical Strategies to Enhance Retention in Care within HIV Treatment Programs in East Africa. Value Health 18:946-55
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