Abstract for: Needs assessment for developing a System Dynamic HIV Drug Resistance Prevention Model: A triangulation approach

System dynamic modeling can serve as a decision support tool for understanding complex problems like HIV Drug Resistance (HIVDR) and analyzing outcomes of theorized interventions. Rising levels of HIVDR present a significant risk to achieving the UNAIDS goal of viral suppression in 95% of individuals receiving treatment by 2030. This study aims to align global targets, stakeholder priorities, and evidence gaps to guide the focus of systems modeling for HIVDR prevention. A triangulation approach was used whereby data for needs assessment was obtained from three sources: (1) Rapid participatory appraisal of stakeholders in the form of group model building workshops (2) Systematic review of the evidence for HIVDR intervention models and, (3) scoping review of global guidelines and policies on HIVDR. A casual loop diagram (CLD) was developed to represent stakeholder priorities. The needs of each group were compared in a Venn diagram. In this assessment, the WHO global action plan on HIVDR was identified in the literature and represented global targets of resistance prevention and response, monitoring and surveillance, research and innovation, laboratory capacity and governance and enabling mechanisms. Stakeholder-prioritized interventions focused on improving financial stability and quality of care and reducing stigmatization. Some overlaps between the priorities were observed. Available HIVDR models did not address all global or stakeholder priorities. There is a need for comprehensive HIVDR prevention models that cover all strategic objectives and consider stakeholder priorities in model development and intervention design. Systems modeling can potentially provide a much-needed holistic view of the problem and guide intervention selection. Adequate stakeholder engagement is necessary to increase model validity and ensure the smooth adoption of interventions.