Abstract
BackgroundThe United States Centers for Disease Control and Prevention estimates that approximately 60,000 US youth are living with HIV. US youth living with HIV (YLWH) have poorer outcomes compared with adults, including lower rates of diagnosis, engagement, retention, and virologic suppression. With Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) support, new trials of youth-centered interventions to improve retention in care and medication adherence among YLWH are underway.ObjectiveThis study aimed to use a computer simulation model, the Cost-Effectiveness of Preventing AIDS Complications (CEPAC)-Adolescent Model, to evaluate selected ongoing and forthcoming ATN interventions to improve viral load suppression among YLWH and to define the benchmarks for uptake, effectiveness, durability of effect, and cost that will make these interventions clinically beneficial and cost-effective.MethodsThis protocol, ATN 161, establishes the ATN Modeling Core. The Modeling Core leverages extensive data—already collected by successfully completed National Institutes of Health–supported studies—to develop novel approaches for modeling critical components of HIV disease and care in YLWH. As new data emerge from ongoing ATN trials during the award period about the effectiveness of novel interventions, the CEPAC-Adolescent simulation model will serve as a flexible tool to project their long-term clinical impact and cost-effectiveness. The Modeling Core will derive model input parameters and create a model structure that reflects key aspects of HIV acquisition, progression, and treatment in YLWH. The ATN Modeling Core Steering Committee, with guidance from ATN leadership and scientific experts, will select and prioritize specific model-based analyses as well as provide feedback on derivation of model input parameters and model assumptions. Project-specific teams will help frame research questions for model-based analyses as well as provide feedback regarding project-specific inputs, results, sensitivity analyses, and policy conclusions.ResultsThis project was funded as of September 2017.ConclusionsThe ATN Modeling Core will provide critical information to guide the scale-up of ATN interventions and the translation of ATN data into policy recommendations for YLWH in the United States.
Highlights
BackgroundApproximately 60,000 youth are living with HIV in the United States
The AIDS Interventions (ATN) Modeling Core will provide critical information to guide the scale-up of ATN interventions and the translation of ATN data into policy recommendations for youth living with HIV (YLWH) in the United States. (JMIR Res Protoc 2019;8(4):e9898) doi:10.2196/resprot
ATN collaborations have included the United States Centers for Disease Control and Prevention; the Health Resources and Services Administration; the AIDS Clinical Trials Group; the HIV Vaccine Trials Network; the HIV Prevention Trials Network; the International Maternal, Pediatric, and Adolescent AIDS Clinical Trial (IMPAACT) Network; and the Microbicide Trials Network. This ATN began with new National Institutes of Health (NIH) support in 2016 to fund youth-focused projects that aim to reduce risk factors for adolescents at risk of acquiring HIV and to promote behaviors related to adherence and engagement with care for those living with HIV
Summary
BackgroundApproximately 60,000 youth are living with HIV in the United States. Youth living with HIV (YLWH) have poorer outcomes than adults living with HIV, including lower rates of diagnosis, engagement, retention, and virologic suppression [1,2]. ATN collaborations have included the United States Centers for Disease Control and Prevention; the Health Resources and Services Administration; the AIDS Clinical Trials Group; the HIV Vaccine Trials Network; the HIV Prevention Trials Network; the International Maternal, Pediatric, and Adolescent AIDS Clinical Trial (IMPAACT) Network; and the Microbicide Trials Network. This ATN began with new National Institutes of Health (NIH) support in 2016 to fund youth-focused projects that aim to reduce risk factors for adolescents at risk of acquiring HIV and to promote behaviors related to adherence and engagement with care for those living with HIV. With Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) support, new trials of youth-centered interventions to improve retention in care and medication adherence among YLWH are underway.
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