More realistic models of sexually transmitted disease transmission dynamics - Sexual partnership networks, pair models, and moment closure

Background: Mathematical models of sexually transmitted disease transmission have proven powerful tools for interpreting observed epidemiologic pattern. However, the most commonly used formulation of such models largely fail to capture the effect of partnership concurrency and contact network structure on transmission. Goal: The development of a compartmental model of partnership formation and dissolution that includes approximations for the influence of the sexual-partner network. Study Design: Theoretical analysis of ordinary differential equation models for sexually transmitted disease transmission within sex-partner networks. Results: The approach developed advances earlier pair models, allows for the influence of concurrent sexual partnerships, and illustrates the importance of concurrency to the persistence of diseases with relatively short durations of infectiousness. The authors also illustrate that heterogeneity in risk is possible even in model populations in which all individuals follow the same behavioral rules. Conclusion: Deterministic extended pair models offer a powerful approach to modelling sexually transmitted disease transmission that usefully complement computationally intensive microsimulation models.