HIV infects over 50,000 new people each year in the US. An important reason why HIV transmission persists is not because of an absence of potentially effective interventions, but rather because effective interventions are often not implemented. To address this problem, we have created a proposal that integrates comparative effectiveness research (which compares the effectiveness of different interventions) and operations research (which compares alternative portfolios of interventions, rather than comparing single interventions in isolation). We place particular emphasis on alcohol because it is a common modifiable risk factor for HIV transmission and is a common modifiable risk factor for HIV progression. Because unsafe alcohol use often occurs together with multi-substance use (MSU) and depression, because they often act on similar pathways to impact HIV transmission, our proposal considers portfolios of interventions that can address these oft-intertwined behaviors simultaneously or in a sequenced, prioritized progression. We also consider intervention designs that can be further tailored based on individual patient characteristics such as age and comorbidity burden. We seek to implement this operations research model within an interactive web-based laboratory that aims to improve research methods by encouraging greater """"""""cross-talk"""""""" between modeling, observational data analysis, and trial design;and by identify patient groups that may particularly benefit from interventions, or tailoring results to the needs of particular stakeholders.

Public Health Relevance

This proposal will create an interactive, web-based simulation model of HIV transmission that can help decision makers prioritize which intervention designs are most effective by tailoring results to patients and feasibility constraints.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01AA020799-02
Application #
8328941
Study Section
Special Emphasis Panel (ZAA1-DD (04))
Program Officer
Roach, Deidra
Project Start
2011-09-06
Project End
2016-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
2
Fiscal Year
2012
Total Cost
$225,000
Indirect Cost
$91,864
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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Justice, Amy C; Gordon, Kirsha; Skanderson, Melissa et al. (2018) Non antiretroviral polypharmacy and adverse health outcomes among HIV-infected and uninfected individuals. AIDS :
Ruggles, Kelly V; Fang, Yixin; Tate, Janet et al. (2017) What are the Patterns Between Depression, Smoking, Unhealthy Alcohol Use, and Other Substance Use Among Individuals Receiving Medical Care? A Longitudinal Study of 5479 Participants. AIDS Behav 21:2014-2022
Hogg, Robert S; Eyawo, Oghenowede; Collins, Alexandra B et al. (2017) Health-adjusted life expectancy in HIV-positive and HIV-negative men and women in British Columbia, Canada: a population-based observational cohort study. Lancet HIV 4:e270-e276
Herrin, Melissa; Tate, Janet P; Akgün, Kathleen M et al. (2016) Weight Gain and Incident Diabetes Among HIV-Infected Veterans Initiating Antiretroviral Therapy Compared With Uninfected Individuals. J Acquir Immune Defic Syndr 73:228-36
Yin, Michael T; Shiau, Stephanie; Rimland, David et al. (2016) Fracture Prediction With Modified-FRAX in Older HIV-Infected and Uninfected Men. J Acquir Immune Defic Syndr 72:513-20

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