HIV spread and partnership reduction for different patterns of sexual behaviour - a study with the microsimulation model STDSIM
AbstractWe studied how sexual behaviour affects population HIV spread simulating stylized risk profiles: (1) prostitution, no short relationships (resembling settings in South-East Asia); (2) prostitution, concurrent short relationships (resembling South-America and urban sub-Saharan Africa); (3) no prostitution, concurrent short relationships (resembling rural sub-Saharan Africa); (4) prostitution, serial short relationships (a generic low-risk setting). We explored the impact on HIV prevalence of prevention programs accomplishing postponement of sexual debut, reduction in partner change rate and in prostitution. We described the representation of sexual behaviour in the microsimulation model STDSIM, comparing it to non-individual-based models. The profiles generate markedly different time courses of HIV spread. Concentration of risk causes a rapid initial spread (Profiles 1 and 2), whereas the final prevalence depends more on the overall extent of risk behaviour in the general population (highest for Profiles 2 and 3). Effects of partnership reduction are strongly context dependent. Small decreases in numbers of partners reduce HIV spread considerably if they reflect decreases in the contacts of highest risk in that setting. In settings with risk behaviour dispersed over a large part of the population (Profiles 2 and 3), indirect effects can cause the impact on HIV to be disproportionately large compared to the magnitude of behaviour change.
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Bibliographic InfoArticle provided by Taylor & Francis Journals in its journal Mathematical Population Studies.
Volume (Year): 8 (2000)
Issue (Month): 2 ()
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Web page: http://www.tandfonline.com/GMPS20
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- Leigh Johnson & Rob Dorrington & Debbie Bradshaw & Victoria Pillay-Van Wyk & Thomas Rehle, 2009. "Sexual behaviour patterns in South Africa and their association with the spread of HIV: insights from a mathematical model," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 21(11), pages 289-340, September.
- Leigh F. Johnson & Rob Dorrington, 2006. "Modelling the demographic impact of HIV/AIDS in South Africa and the likely impact of interventions," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 14(22), pages 541-574, June.
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