From compartments to networks : model complexity and infectious disease policy
Abstract/Contents
- Abstract
- The opioid abuse epidemic in the United States calls for new and cost-effective policies to address the rise of morbidity and mortality associated with drug injection. This dissertation explores how, and the extent to which, mathematical modeling can inform policy interventions surrounding HIV for people who inject drugs (PWID). First, we develop a dynamic compartmental model empirically calibrated to the US HIV epidemic to assess the cost-effectiveness of HIV preexposure chemoprophylaxis (PrEP) for PWID. We identify the optimal delivery scenario for PrEP but nonetheless find that it is not likely to be cost-effective. Next, we consider PrEP within a context of other HIV interventions. We find that an optimal portfolio of opioid agonist therapy (OAT), needle syringe exchange programs, and test and treat programs can deliver greater health benefit for less cost than PrEP. Although PrEP averts more infection than OAT, OAT provides more value because of its immediate quality of life improvements for an individual with high competing mortality risks. Finally, to explore how structural modeling assumptions influence policy conclusions, we perform a case study of a potential HIV vaccination across a family of linked models. We find that aggregating individuals into compartments biases us towards intervention, an effect most pronounced when targeting to smaller populations. Parameter complexity, although it has little effect on network models in this context, can mitigate overestimation effects in compartmental models.
Description
| Type of resource | text |
|---|---|
| Form | electronic resource; remote; computer; online resource |
| Extent | 1 online resource. |
| Place | California |
| Place | [Stanford, California] |
| Publisher | [Stanford University] |
| Copyright date | 2018; ©2018 |
| Publication date | 2018; 2018 |
| Issuance | monographic |
| Language | English |
Creators/Contributors
| Author | Bernard, Cora Lynn | |
|---|---|---|
| Degree supervisor | Brandeau, Margaret L | |
| Thesis advisor | Brandeau, Margaret L | |
| Thesis advisor | Goldhaber-Fiebert, Jeremy D | |
| Thesis advisor | Owens, Doug | |
| Degree committee member | Goldhaber-Fiebert, Jeremy D | |
| Degree committee member | Owens, Doug | |
| Associated with | Stanford University, Department of Management Science and Engineering. |
Subjects
| Genre | Theses |
|---|---|
| Genre | Text |
Bibliographic information
| Statement of responsibility | Cora Lynn Bernard. |
|---|---|
| Note | Submitted to the Department of Management Science and Engineering. |
| Thesis | Thesis Ph.D. Stanford University 2018. |
| Location | electronic resource |
Access conditions
- Copyright
- © 2018 by Cora Lynn Bernard
- License
- This work is licensed under a Creative Commons Attribution Non Commercial 3.0 Unported license (CC BY-NC).
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