Optimizing an HIV testing program using a system dynamics model of the continuum of care.

Area of Science:

• Public Health
• Health Services Research
• Mathematical Modeling

Background:

• Effective antiretroviral therapy (ART) delivery is crucial for managing human immunodeficiency virus (HIV) infection.
• Efficient HIV-related health service delivery is essential to maximize individual and population benefits of ART.

Purpose of the Study:

• To develop a system dynamics model of the HIV care continuum in Vancouver, Canada.
• To incorporate an HIV transmission component to assess operational interventions' impact on population health.
• To determine optimal resource allocation for testing programs to minimize new HIV infections over five years.

Main Methods:

• Developed a system dynamics model of the HIV care continuum.
• Included key activities: HIV testing, linkage to care, and retention in care and treatment.
• Integrated an HIV transmission model to evaluate intervention impacts.

Main Results:

• Identified optimal resource allocations for targeted and routine HIV testing programs.
• Simulations projected the minimization of new HIV infections within a five-year timeframe.
• Model scenarios were informed by local health policy and constraints.

Conclusions:

• System dynamics modeling provides a framework for optimizing HIV care delivery.
• Strategic resource allocation in HIV testing can significantly reduce new infections.
• Collaborative efforts with healthcare providers are vital for effective public health interventions.