从概念化到建模HIV传播动态模型中的结构决定因素和干预措施:基于证据的分析的范围审查和方法框架
James Stannah1, Jorge Luis Flores Anato1, Michael Pickles2,3
1Department of Epidemiology and Biostatistics, School of Population and Global Health, McGill University, Montréal, Canada.
BMC medicine
|September 19, 2024
概括
动态的艾滋病毒传播模型需要更好地纳入像耻辱和犯罪化这样的结构性决定因素. 未来的模型应该动态地代表这些因素及其因果路径,以便更准确地预测艾滋病毒负担和不平等.
科学领域:
- 流行病学 流行病学
- 数学建模的数学建模
- 公共卫生 公共卫生
背景情况:
- 结构性决定因素 (例如,犯罪,耻辱,性别规范) 显著影响艾滋病毒传播动态和人口层面的结果.
- 准确地建模这些决定因素是具有挑战性的,因为对因果路径和经验数据的理解有限.
研究的目的:
- 对包含结构性决定因素的动态艾滋病毒传播建模研究进行范围审查.
- 制定一个方法框架和建议,以改善在艾滋病毒模型中纳入结构决定因素.
主要方法:
- 在2023年8月28日之前使用Embase和Medline发表的艾滋病毒传播建模研究的范围审查.
- 评估研究如何代表暴露于结构决定因素及其因果途径的评估.
- 开发一个方法框架,并为未来的建模提出建议.
主要成果:
- 确定了17项研究,重点关注监禁,对妇女的暴力,耻辱和住房不稳定等决定因素.
- 大多数研究都以动态模式对暴露进行建模,但因果途径往往被简化,并基于横截面数据.
- 不到一半的研究验证了使用结构决定因素的流行率或影响数据的模型.
结论:
- 数学模型对于了解结构性决定因素对艾滋病毒的影响至关重要.
- 下一代模型应该通过纵向证据来动态和机械地表示结构决定因素及其因果路径.
- 改进的建模将提高HIV干预和政策预测的有效性和实用性.
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