Koopman J, Jacquez J, Simon C; International Conference on AIDS.
Int Conf AIDS. 1989 Jun 4-9; 5: 151 (abstract no. Th.A.P.64).
University of Michigan, Dept. of Epidemiology SPH-1, 109 Observatory, Ann Arbor, MI, USA
OBJECTIVE: Provide a mathematical and theoretical context as well as questionnaire suggestions for the study of sexual and needle contact patterns affecting the course of the AIDS epidemic. METHODS: We have developed a mathematical theory and model of contact structure which proceeds from the assumption that there are two forces creating heterogenous sexual and needle contact patterns in a population. The first is the choice of social contexts for meeting potential sexual patterns. We model this with a formulation called "Structured mixing". The second is the degree of selectivity exercised in choosing partners among those who are encountered in these social contexts. We model this with a formulation called "Selective mixing". RESULTS: The two formulations combine into one overall theory in different ways depending upon how information is collected on the social contexts of sexual or needle sharing partnerships. Information may be collected on the social contexts where actual partnerships were made, on where sexual attraction was felt or the opportunity to share needles presented itself, or on more general social contacts. For each of these approaches, there are different approaches required to collect information on the selection of partners. We demonstrate how predictions of the future course of the epidemic and estimates of the relative risk of oral and anal sex are very sensitive to contact structure information. We also illustrate how to collect such information. CONCLUSION: Epidemiologists have tended to disregard questions about who has sex or shares needles with whom in their investigations because they lack an overall theory to guide the collection and analysis of such information. This deficiency could be causing us to misjudge the risks associated with different behaviors (especially to underestimate the risk associated with oral sex). It is also retarding the analyses of where we might expect the epidemic to spread next. Our structured and selective mixing model provides a basis to overcome this deficiency.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Biomedical Research
- Demography
- Disease Outbreaks
- Disease Transmission, Horizontal
- HIV Infections
- HIV Seropositivity
- Models, Biological
- Needle Sharing
- Sexual Behavior
- transmission
Other ID:
UI: 102176470
From Meeting Abstracts