Progression and Transmission of HIV/AIDS (PATH 2.0): A New, Agent-Based Model to Estimate HIV Transmissions in the United States
Authored by Chaitra Gopalappa, Paul G Farnham, Yao-Hsuan Chen, Stephanie L Sansom
Date Published: 2017
DOI: 10.1177/0272989x16668509
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Model Documentation:
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Abstract
Background. HIV transmission is the result of complex dynamics in the
risk behaviors, partnership choices, disease stage and position along
the HIV care continuumindividual characteristics that themselves can
change over time. Capturing these dynamics and simulating transmissions
to understand the chief sources of transmission remain important for
prevention. Methods. The Progression and Transmission of HIV/AIDS (PATH
2.0) is an agent-based model of a sample of 10,000 people living with
HIV (PLWH), who represent all men who have sex with men (MSM) and
heterosexuals living with HIV in the U.S.A. Persons uninfected were
modeled as populations, stratified by risk and gender. The model
included detailed individual-level data from several large national
surveillance databases. The outcomes focused on average annual
transmission rates from 2008 through 2011 by disease stage, HIV care
continuum, and sexual risk group. Results. The relative risk of
transmission of those in the acute phase was nine-times [5(th) and
95(th) percentile simulation interval (SI): 7, 12] that of those in the
non-acute phase, although, on average, those with acute infections
comprised 1\% of all PLWH. The relative risk of transmission was 24- to
50-times as high for those in the non-acute phase who had not achieved
viral load suppression as compared with those who had. The relative risk
of transmission among MSM was 3.2-times [SI: 2.7, 4.0] that of
heterosexuals. Men who have sex with men and women generated 46\% of
sexually acquired transmissions among heterosexuals. Conclusions. The
model results support a continued focus on early diagnosis, treatment
and adherence to ART, with an emphasis on prevention efforts for MSM, a
subgroup of whom appear to play a role in transmission to heterosexuals.
Tags
Simulation
Infection
Risk
Prevention
Men
Condom use
Behavioral surveillance system
Decision analysis
Hiv and aids
Simulation methods (monte carlo methods
Etc)
Risk communication or risk perception
National probability sample
Testing
behaviors
Perceived health
Sexual-behaviors