Modeling the gender-specific impact of vaginal microbicides on HIV transmission

JOURNAL OF THEORETICAL BIOLOGY

卷:288

Article

Dimitrov, Dobromir T.¹  Boily, Marie-Claude²  Baggaley, Rebecca F.²  Masse, Benoit^1,3 

[1] Fred Hutchinson Canc Res Ctr, Stat Ctr HIV AIDS Res & Prevent, Seattle, WA 98109 USA

[2] Univ London Imperial Coll Sci Technol & Med, Fac Med, Dept Infect Dis Epidemiol, London, England

[3] Univ Montreal, CHU St Justine Res Ctr, Montreal, PQ, Canada

关键词: Mathematical model;    Epidemic;    Biomedical intervention;    Prevention;    Drug resistance;   

DOI  :  10.1016/j.jtbi.2011.08.001

来源: Elsevier

【 摘 要 】

Vaginal microbicides (VMB) are currently among the few women-initiated biomedical interventions for preventing heterosexual transmission of HIV. In this paper we use a deterministic model of HIV transmission to assess the public-health benefits of a VMB intervention and evaluate its gender-specific impact over short (initial) and extended periods of time. We define two distinct quantitative benefit ratios (QBRs) based on infections prevented in men and women to create and study regions of male advantage in different parameter spaces. Our analysis exposes complicated temporal correlations between the QBRs and series of pre-intervention (e.g., HIV acquisition risks per act) and intervention parameters (e.g., VMB efficacy mechanisms, rates of resistance development and reversion) and indicates that different QBRs may often disagree on the gender distribution of the benefits from a VMB intervention. We also outline the strong influence of some modeling assumptions on the reported results and conclude that the assessment of VMB and other biomedical interventions must be based on more comprehensive analyses than calculations of infections prevented over a fixed period of time. (C) 2011 Elsevier Ltd. All rights reserved.

【 授权许可】

Free