title: Data-driven decision-making tools to improve public resource allocation for care and prevention of HIV/AIDS.
abstract: Public health agencies face difficult decisions when allocating scarce resources to control the spread of HIV/AIDS. Decisions are often made with few local empirical data. We demonstrated the use of the robust decision making approach in Los Angeles County, an approach that is data driven and allows decision makers to compare the performance of various intervention strategies across thousands of simulated future scenarios. We found that the prevailing strategy of emphasizing behavioral risk reduction interventions was unlikely to achieve the policy goals of the national HIV/AIDS strategy. Of the alternative strategies we examined, those that invested most heavily in interventions to initiate antiretroviral treatment and support treatment adherence were the most likely to achieve policy objectives. By employing similar methods, other public health agencies can identify robust strategies and invest in interventions more likely to achieve HIV/AIDS policy goals.
authors.forename: Gery W
authors.initials: GW
authors.lastname: Ryan
authors.forename: Evan W
authors.initials: EW
authors.lastname: Bloom
authors.forename: David J
authors.initials: DJ
authors.lastname: Lowsky
authors.forename: Mark T
authors.initials: MT
authors.lastname: Linthicum
authors.forename: Timothy
authors.initials: T
authors.lastname: Juday
authors.forename: Lisa
authors.initials: L
authors.lastname: Rosenblatt
authors.forename: Sonali
authors.initials: S
authors.lastname: Kulkarni
authors.forename: Dana P
authors.initials: DP
authors.lastname: Goldman
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Sayles
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy* / Q000635:transmission; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D040343:Behavioral Risk Factor Surveillance System; D002140:California; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D058872:Epidemics / Q000517:prevention & control* / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy* / Q000635:transmission; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006291:Health Policy; D006801:Humans; D008297:Male; D055118:Medication Adherence; D009937:Organizational Objectives; D014481:United States
chemical_list: D019380:Anti-HIV Agents
keywords: AIDS/HIV; Decision Support; Public Health; Public Resource Allocation; State/Local Issues