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The impact of social determinants, conditional cash transfers and primary health care on HIV/AIDS: an integrated retrospective and forecasting approach based on a cohort of 100 million Brazilians

Award Number: R01AI152938
ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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Proposal Title: The impact of social determinants, conditional cash transfers and primary health care on HIV/AIDS: an integrated retrospective and forecasting approach based on a cohort of 100 million Brazilians Project Summary Considerable progress has been made in controlling many aspects of the HIV/AIDS epidemic. But challenges remain in terms of scaling up successful national programs. This study will contribute to knowledge on the impact of large-scale initiatives addressing both the social and medical determinants of HIV/AIDS by combining data from Brazil’s national HIV/AIDS registry with other largescale databases including the “100 Million Brazilian Cohort”: a virtual cohort of more than 100 million individuals over 18 years obtained by the linkage of large countrywide socioeconomic and health datasets. It will be the first study to follow such a large number of individuals over time and in non-experimental conditions to understand how social determinants, conditional cash transfers and primary health care affect HIV/AIDS incidence, hospitalization and mortality; and how receipt of social protections at the individual level affects HIV/AIDS outcomes (ART adherence and mortality). Thanks to the unprecedented dimension of the dataset and the methods proposed, we will assess impact heterogeneities of the two interventions in a large range of different subpopulations, as well as possible synergistic effects. Using the longitudinal aspect of the cohort we will explore and assess in depth expected and unexpected dynamics, lagged and long- term effects of changes in living conditions and in exposures to conditional cash transfers and community- based primary health care. We will then expand the cohort and integrate estimates from the retrospective evaluations with the development of forecasting for several alternative policy scenarios. Using an innovative joined microsimulation and agent-based model we will be able to forecast the effects of the current Brazilian economic crisis, overall and for several subpopulations, on the HIV/AIDS epidemic. We will forecast and compare the impact of a wide range of alternative policy scenarios, such as the maintenance of current levels of support of conditional cash transfer and primary care, reductions of coverage and benefits due to fiscal austerity measures, or expansion in different subpopulation and with different dynamics. We will calibrate and select the combinations of policy response able to maximize the benefits on the HIV/AIDS epidemic, even during an economic crisis. The empirical results and the innovative mathematical models produced in this project will represent an essential contribution to the understanding and control of HIV/AIDS in lower and middle income country settings, as well as for vulnerable populations in the United States.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2024 ( Subtotal = $360,170 )
2024	2024	FUNDACAO DE APOIO A PESQUISA E A EXTENSAO	RUA PROFESSOR EDGARD MATA 001	SALVADOR				BRA	Allergy and Infectious Diseases Research	000	5	3/29/2024	NON-COMPETING CONTINUATION	$360,170
														Subtotal = $360,170

Issue Date FY: 2023 ( Subtotal = $388,436 )
2023	2023	FUNDACAO DE APOIO A PESQUISA E A EXTENSAO	RUA PROFESSOR EDGARD MATA 001	SALVADOR				BRA	Allergy and Infectious Diseases Research	000	4	3/29/2023	NON-COMPETING CONTINUATION	$388,436
														Subtotal = $388,436

Issue Date FY: 2022 ( Subtotal = $388,563 )
2022	2022	FUNDACAO DE APOIO A PESQUISA E A EXTENSAO FAPEX	AV. MANOEL DIAS DA SILVA 1.784 ED. COM. PITUBA TRADE	SALVADOR	BA			BRA	Allergy and Infectious Diseases Research	000	3	3/17/2022	NON-COMPETING CONTINUATION	$388,563
														Subtotal = $388,563

Issue Date FY: 2021 ( Subtotal = $423,754 )
2021	2021	FUNDACAO DE APOIO A PESQUISA E A EXTENSAO - FAPEX.	RUA CAETANO MOURA 140	SALVADOR	BA			BRA	Allergy and Infectious Diseases Research	000	2	3/24/2021	NON-COMPETING CONTINUATION	$423,754
														Subtotal = $423,754

Issue Date FY: 2020 ( Subtotal = $454,046 )
2020	2020	FUNDACAO DE APOIO A PESQUISA E A EXTENSAO - FAPEX.	RUA CAETANO MOURA 140	SALVADOR	BA	40210-340		BRA	Allergy and Infectious Diseases Research	002	1	6/18/2020	NEW	$454,046
2020	2020	FUNDACAO DE APOIO A PESQUISA E A EXTENSAO - FAPEX.	RUA CAETANO MOURA 140	SALVADOR	BA	40210-340		BRA	Allergy and Infectious Diseases Research	000	1	3/25/2020	NEW	$454,046
2020	2020	FUNDACAO DE APOIO A PESQUISA E A EXTENSAO - FAPEX.	RUA CAETANO MOURA 140	SALVADOR	BA	40210-340		BRA	Allergy and Infectious Diseases Research	001	1	6/16/2020	NEW	-$454,046
														Subtotal = $454,046

Grand Total All Awards = $2,014,969

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The impact of social determinants, conditional cash transfers and primary health care on HIV/AIDS: an integrated retrospective and forecasting approach based on a cohort of 100 million Brazilians

Award Number: R01AI152938

ORGANIZATION: NATIONAL INSTITUTE OF ALLERGY & INFECTIOUS DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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