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Developing a dynamic HIV transmission model for 6 U.S. cities: An evidence synthesis.
- Source :
-
PloS one [PLoS One] 2019 May 30; Vol. 14 (5), pp. e0217559. Date of Electronic Publication: 2019 May 30 (Print Publication: 2019). - Publication Year :
- 2019
-
Abstract
- Background: Dynamic HIV transmission models can provide evidence-based guidance on optimal combination implementation strategies to treat and prevent HIV/AIDS. However, these models can be extremely data intensive, and the availability of good-quality data characterizing regional microepidemics varies substantially within and across countries. We aim to provide a comprehensive and transparent description of an evidence synthesis process and reporting framework employed to populate and calibrate a dynamic, compartmental HIV transmission model for six US cities.<br />Methods: We executed a mixed-method evidence synthesis strategy to populate model parameters in six categories: (i) initial HIV-negative and HIV-infected populations; (ii) parameters used to calculate the probability of HIV transmission; (iii) screening, diagnosis, treatment and HIV disease progression; (iv) HIV prevention programs; (v) the costs of medical care; and (vi) health utility weights for each stage of HIV disease progression. We identified parameters that required city-specific data and stratification by gender, risk group and race/ethnicity a priori and sought out databases for primary analysis to augment our evidence synthesis. We ranked the quality of each parameter using context- and domain-specific criteria and verified sources and assumptions with our scientific advisory committee.<br />Findings: To inform the 1,667 parameters needed to populate our model, we synthesized evidence from 59 peer-reviewed publications and 24 public health and surveillance reports and executed primary analyses using 11 data sets. Of these 1,667 parameters, 1,517 (91%) were city-specific and 150 (9%) were common for all cities. Notably, 1,074 (64%), 201 (12%) and 312 (19%) parameters corresponded to categories (i), (ii) and (iii), respectively. Parameters ranked as best- to moderate-quality evidence comprised 39% of the common parameters and ranged from 56%-60% across cities for the city-specific parameters. We identified variation in parameter values across cities as well as within cities across risk and race/ethnic groups.<br />Conclusions: Better integration of modelling in decision making can be achieved by systematically reporting on the evidence synthesis process that is used to populate models, and by explicitly assessing the quality of data entered into the model. The effective communication of this process can help prioritize data collection of the most informative components of local HIV prevention and care services in order to reduce decision uncertainty and strengthen model conclusions.<br />Competing Interests: The authors have declared that no competing interests exist.
- Subjects :
- Acquired Immunodeficiency Syndrome transmission
Acquired Immunodeficiency Syndrome virology
Cities epidemiology
Epidemiologic Studies
HIV Infections transmission
HIV Infections virology
Humans
Pre-Exposure Prophylaxis
Risk Factors
Sexual and Gender Minorities
United States epidemiology
Acquired Immunodeficiency Syndrome epidemiology
Antiretroviral Therapy, Highly Active
HIV pathogenicity
HIV Infections epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1932-6203
- Volume :
- 14
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- PloS one
- Publication Type :
- Academic Journal
- Accession number :
- 31145752
- Full Text :
- https://doi.org/10.1371/journal.pone.0217559