Journal
EPIDEMICS
Volume 2, Issue 3, Pages 155-164Publisher
ELSEVIER
DOI: 10.1016/j.epidem.2010.06.003
Keywords
HIV; Networks; Serosorting; Concurrency
Categories
Funding
- NIH [T32 AI07384, R01 AI078752, 1R21 DA024611-01]
- Royal Society
- NSF [DEB-0749097]
- James S. McDonnell Foundation
- Santa Fe Institute
- Division Of Environmental Biology
- Direct For Biological Sciences [0749097] Funding Source: National Science Foundation
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The risk of acquiring sexually transmitted infections (STIs) depends on individual behavior and the network of risky partnerships in which an individual participates. STI epidemics often spread rapidly and primarily among individuals central to transmission networks; and thus they often defy the mass-action principle since incidence is not proportional to the infectious fraction of the population. Here, we estimate the contact network structure for an Atlanta, Georgia community with heterogeneous sexual and drug-related risk behaviors and build a detailed transmission model for HIV through this population. We show that accurate estimation of epidemic incidence requires careful measurement and inclusion of diverse factors including concurrency (having multiple partners), the duration of partnerships, serosorting (preference for partners with matching disease state), and heterogeneity in the number and kinds of partners. In the focal population, we find that injection drug users (IDUs) do not directly cause many secondary infections; yet they bridge the heterosexual and men-who-have-sex-with-men (MSM) populations and are thereby indirectly responsible for extensive transmission. (C) 2010 Elsevier B.V. All rights reserved.
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