Are Ending the HIV Epidemic goals attainable across race/ethnic groups, risk groups, and settings?

Modified Abstract: In collaboration with the Shelby County Health Department, which has jurisdiction over Memphis as well as rural northwest Mississippi and Arkansas, we propose to inform policy decisions towards improving HIV outcomes for population-level and subgroup-specific HIV goals in three different settings that together typify high incidence locations in the U.S. HIV epidemic (New York City, Memphis, and northwest Mississippi). We will use mathematical modeling to simulate alternative ways to distribute resources across interventions, settings, and target populations to reduce HIV incidence and improve overall health. Our analyses will be distinguished by incorporating screening and responding to CASM conditions (Conditions of Alcohol, Substance and Mood), measures of dispersion-aversion (i.e., willingness to trade-off some aggregate benefit in order to distribute it more evenly) towards vulnerable subgroups, and the promising new modalities of long-acting-injectable PrEP and ART. Our partners at the Shelby County Health Department and their larger group of stakeholders will provide context on local HIV infection patterns and feasibility and acceptability constraints to inform modeling analyses. Modified Narrative: In collaboration with the Shelby County Health Department and other health jurisdictions, we will simulate alternative policies to maximally reduce HIV incidence and improve overall health in three settings (New York City, Memphis, and northwest Mississippi). We will place special emphasis on the role of alcohol, substance and mood disorders on HIV transmission and progression. We will also incorporate measures to address uneven health burden in vulnerable subgroups.