Rapid initiation of antiretroviral therapy in Turkey: a modeling study.

Background: To effectively control the HIV epidemic and meet global targets, policymakers recommend the rapid initiation of antiretroviral therapy (ART). Our study aims to investigate the effect of rapid ART programs on individuals diagnosed with HIV, considering varying coverage and initiation days after diagnosis, and compare it to standard-of-care ART treatment in Turkey.

Methods: We used a dynamic compartmental model to simulate the dynamics of HIV infection in Turkey.

Modeling the future of HIV in Turkey: Cost-effectiveness analysis of improving testing and diagnosis.

Aims: This study aimed to determine HIV incidence and prevalence in Turkey and to estimate the cost-effectiveness of improving testing and diagnosis in the next 20 years.

Background: HIV incidence in Turkey has been rapidly increasing in the last decade with a particularly high rate of infection for younger populations, which underscores the urgent need for a robust prevention program and improved testing capacity for HIV.

Methods: We developed a dynamic compartmental model of HIV transmission and progression among the Turkish population aged 15-64 and assessed the effect of improving testing and diagnosis.

Cost-effectiveness analysis of fissure sealants for caries prevention in children.

Objective: To evaluate the cost-effectiveness of resin-based and glass ionomer-based fissure sealants compared with no intervention for children.

Methods: We developed a Markov-based decision analytic model that simulated Turkish children from aged 6 to 15 years. Two types of costs were explored from the payers' perspective and the health care system perspectives.

[Evaluation of Non-Pharmaceutical Interventions for Reducing Contact Rate in COVID-19 Pandemic: R0 Estimation and Modeling for Istanbul].

After the declaration of the coronavirus-2019 (COVID-19) pandemic and the detection of the COVID-19 case in Turkey, a series of non-pharmaceutical measures were implemented to reduce the number of contacts at the national level. The aim of this study was to determine the change in the epidemic reproduction rate (R0) with non-pharmaceutical interventions including curfews starting with the first reported case in Istanbul and to evaluate the effectiveness of interventions by estimating the number of cases and deaths using a dynamic compartmental model. While keeping transmission probability (beta) as 3% and incubation period as seven days, we developed five scenarios that represented nonpharmaceutical interventions The first scenario was "if nothing was done" and the last scenario was "curfew".

Optimal allocation of HIV prevention funds for state health departments.

Objective: To estimate the optimal allocation of Centers for Disease Control and Prevention (CDC) HIV prevention funds for health departments in 52 jurisdictions, incorporating Health Resources and Services Administration (HRSA) Ryan White HIV/AIDS Program funds, to improve outcomes along the HIV care continuum and prevent infections.

Methods: Using surveillance data from 2010 to 2012 and budgetary data from 2012, we divided the 52 health departments into 5 groups varying by number of persons living with diagnosed HIV (PLWDH), median annual CDC HIV prevention budget, and median annual HRSA expenditures supporting linkage to care, retention in care, and adherence to antiretroviral therapy. Using an optimization and a Bernoulli process model, we solved for the optimal CDC prevention budget allocation for each health department group.

Impact of Improved HIV Care and Treatment on PrEP Effectiveness in the United States, 2016-2020.

Background: The effect of improving diagnosis, care, and treatment of persons living with HIV (PLWH) on pre-exposure prophylaxis (PrEP) effectiveness in the United States has not been well established.

Methods: We used a dynamic, compartmental model that simulates the sexually active US population. We investigated the change in cumulative HIV incidence from 2016 to 2020 for 3 HIV care-continuum levels and the marginal benefit of PrEP compared with each.

Cost-Effectiveness of Frequent HIV Testing of High-Risk Populations in the United States.

Purpose: Data showing a high incidence of HIV infection among men who have sex with men (MSM) who had annual testing suggest that more frequent HIV testing may be warranted. Testing technology is also a consideration given the availability of sensitive testing modalities and the increased use of less-sensitive rapid, point-of-care antibody tests. We assessed the cost-effectiveness of HIV testing of MSM and injection drug users (IDUs) at 3- and 6-month intervals using fourth-generation and rapid tests.

From Theory to Practice: Implementation of a Resource Allocation Model in Health Departments.

Objective: To develop a resource allocation model to optimize health departments' Centers for Disease Control and Prevention (CDC)-funded HIV prevention budgets to prevent the most new cases of HIV infection and to evaluate the model's implementation in 4 health departments.

Design, Settings, And Participants: We developed a linear programming model combined with a Bernoulli process model that allocated a fixed budget among HIV prevention interventions and risk subpopulations to maximize the number of new infections prevented. The model, which required epidemiologic, behavioral, budgetary, and programmatic data, was implemented in health departments in Philadelphia, Chicago, Alabama, and Nebraska.

Systems engineering methods for enhancing the value stream in public health preparedness: the role of Markov models, simulation, and optimization.

Objectives: Large-scale incidents such as the 2009 H1N1 outbreak, the 2011 European Escherichia coli outbreak, and Hurricane Sandy demonstrate the need for continuous improvement in emergency preparation, alert, and response systems globally. As questions relating to emergency preparedness and response continue to rise to the forefront, the field of industrial and systems engineering (ISE) emerges, as it provides sophisticated techniques that have the ability to model the system, simulate, and optimize complex systems, even under uncertainty.

Methods: We applied three ISE techniques--Markov modeling, operations research (OR) or optimization, and computer simulation--to public health emergency preparedness.