论文标题
A-Ai-Aignation Desterone for HIV预防艾滋病毒的临床试验,无家可归
Clinical trial of an AI-augmented intervention for HIV prevention in youth experiencing homelessness
论文作者
论文摘要
遇到无家可归者(YEH)的青年受到艾滋病毒感染的巨大风险,这既使他们无法获得稳定的住房,并且在YEH中对边缘化的种族,种族和性别认同群体的年轻人的代表不成比例。卫生公平的关键目标是改善该人群中保护行为的采用。干预的一种有希望的策略是招募YEH人口的同伴领导者,以促进诸如避孕套使用和定期艾滋病毒测试等行为。这提出了一个计算问题:应该选择哪些年轻人作为同伴领导者,以最大程度地提高干预措施的整体影响?我们开发了一个人工智能系统,以优化社区健康环境中的此类社交网络干预措施。我们进行了一项临床试验,在一个大型美国城市的下车中心招收了713 YEH。临床试验将计划与算法的干预措施与年轻人社交网络中最高的节点的干预措施与那些被招募为同伴领导者(公共卫生的标准方法)以及仅观察对照组的临床试验。临床试验的结果表明,AI组中的青年经历了统计上显着的艾滋病毒传播风险行为的显着降低,而其他组中的年轻人则没有。据我们所知,这提供了对AI方法使用的第一个经验验证,以优化社交网络干预的健康。最后,我们讨论了在项目过程中汲取的经验教训,这可能会为未来在社区级干预措施中使用AI的尝试提供帮助。
Youth experiencing homelessness (YEH) are subject to substantially greater risk of HIV infection, compounded both by their lack of access to stable housing and the disproportionate representation of youth of marginalized racial, ethnic, and gender identity groups among YEH. A key goal for health equity is to improve adoption of protective behaviors in this population. One promising strategy for intervention is to recruit peer leaders from the population of YEH to promote behaviors such as condom usage and regular HIV testing to their social contacts. This raises a computational question: which youth should be selected as peer leaders to maximize the overall impact of the intervention? We developed an artificial intelligence system to optimize such social network interventions in a community health setting. We conducted a clinical trial enrolling 713 YEH at drop-in centers in a large US city. The clinical trial compared interventions planned with the algorithm to those where the highest-degree nodes in the youths' social network were recruited as peer leaders (the standard method in public health) and to an observation-only control group. Results from the clinical trial show that youth in the AI group experience statistically significant reductions in key risk behaviors for HIV transmission, while those in the other groups do not. This provides, to our knowledge, the first empirical validation of the usage of AI methods to optimize social network interventions for health. We conclude by discussing lessons learned over the course of the project which may inform future attempts to use AI in community-level interventions.