title: Optimizing an HIV testing program using a system dynamics model of the continuum of care.
abstract: Realizing the full individual and population-wide benefits of antiretroviral therapy for human immunodeficiency virus (HIV) infection requires an efficient mechanism of HIV-related health service delivery. We developed a system dynamics model of the continuum of HIV care in Vancouver, Canada, which reflects key activities and decisions in the delivery of antiretroviral therapy, including HIV testing, linkage to care, and long-term retention in care and treatment. To measure the influence of operational interventions on population health outcomes, we incorporated an HIV transmission component into the model. We determined optimal resource allocations among targeted and routine testing programs to minimize new HIV infections over five years in Vancouver. Simulation scenarios assumed various constraints informed by the local health policy. The project was conducted in close collaboration with the local health care providers, Vancouver Coastal Health Authority and Providence Health Care.
authors.affiliation: The IRMACS Centre, Simon Fraser University, Burnaby, British Columbia, Canada, sarah_kok@sfu.ca.
authors.forename: Sarah
authors.initials: S
authors.lastname: Kok
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Rutherford
authors.forename: Reka
authors.initials: R
authors.lastname: Gustafson
authors.forename: Rolando
authors.initials: R
authors.lastname: Barrios
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: Krisztina
authors.initials: K
authors.lastname: Vasarhelyi
mesh_terms: D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001955:British Columbia / Q000453:epidemiology; D003198:Computer Simulation; D003266:Continuity of Patient Care; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D040841:Resource Allocation / Q000191:economics* / Q000379:methods*
chemical_list: D044966:Anti-Retroviral Agents