Department of Health Management and Policy, University of Michigan, Ann Arbor, MI, USA.
Department of Health Management and Policy and Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, MI, USA.
Value Health. 2020 Nov;23(11):1509-1521. doi: 10.1016/j.jval.2020.08.001. Epub 2020 Sep 10.
This study reviews optimization models for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) resource allocation.
We searched 2 databases for peer-reviewed articles published from January 1985 through August 2019 that describe optimization models for resource allocation in HIV/AIDS. We included models that consider 2 or more competing HIV/AIDS interventions. We extracted data on selected characteristics and identified similarities and differences across models. We also assessed the quality of mathematical disease transmission models based on the best practices identified by a 2010 task force.
The final qualitative synthesis included 23 articles that used 14 unique optimization models. The articles shared several characteristics, including the use of dynamic transmission modeling to estimate health benefits and the inclusion of specific high-risk groups in the study population. The models explored similar HIV/AIDS interventions that span primary and secondary prevention and antiretroviral treatment. Most articles were focused on sub-Saharan African countries (57%) and the United States (39%). There was notable variation in the types of optimization objectives across the articles; the most common was minimizing HIV incidence or maximizing infections averted (87%). Articles that utilized mathematical modeling of HIV disease and transmission displayed variable quality.
This systematic review of the literature identified examples of optimization models that have been applied in different settings, many of which displayed similar features. There were similarities in objective functions across optimization models, but they did not align with global HIV/AIDS goals or targets. Future work should be applied in countries facing the largest declines in HIV/AIDS funding.
本研究回顾了人类免疫缺陷病毒（HIV）和获得性免疫缺陷综合征（AIDS）资源分配的优化模型。
我们在 2 个数据库中搜索了 1985 年 1 月至 2019 年 8 月发表的同行评审文章，这些文章描述了 HIV/AIDS 资源分配的优化模型。我们纳入了考虑 2 种及以上相互竞争的 HIV/AIDS 干预措施的模型。我们提取了选定特征的数据，并确定了模型之间的异同。我们还根据 2010 年一个工作组确定的最佳实践评估了疾病传播数学模型的质量。
最终的定性综合包括 23 篇文章，使用了 14 个独特的优化模型。这些文章有一些共同特征，包括使用动态传播模型来估计健康效益，并将特定的高危人群纳入研究人群。模型探讨了涵盖初级和二级预防以及抗逆转录病毒治疗的类似 HIV/AIDS 干预措施。大多数文章都集中在撒哈拉以南非洲国家（57%）和美国（39%）。文章的优化目标类型存在明显差异；最常见的是降低 HIV 发病率或最大限度地减少可预防的感染（87%）。利用 HIV 疾病和传播数学模型的文章显示出不同的质量。
本文献系统回顾确定了已在不同环境中应用的优化模型示例，其中许多都具有相似的特征。优化模型的目标函数存在相似性，但与全球 HIV/AIDS 目标或指标并不一致。未来的工作应在面临 HIV/AIDS 资金大幅减少的国家开展。
