PubMed Health⌕ Search

PubMed · 3792516

A transmission model for AIDS.

Abstract

Mathematical and computer-simulation models of sexually transmitted diseases, which have been used to study gonorrhoea and human papilloma virus transmissions, are applied to the study of AIDS. The problems of adapting the general model to the new problem, within already established principles, are described; and solutions offered. The objective is to predict equilibrium levels for the prevalence and incidence of HTLV-III infection in the U.K. Within the uncertainties of the available information on sexual behaviour in our society, on the risk of transmission and on the natural history of the infection, the model predicts: the infection will be self-sustaining in the heterosexual as in the homosexual population, the equilibrium prevalence of HTLV-III infection may attain 500-800 per 1000 among promiscuous male homosexuals and female prostitutes: 1 to 5 per 1000 among non-promiscuous heterosexual males and females: and 8 to 15 per 1000 overall, these equilibria will be reached in about 10 years among the promiscuous classes, but not for 40 years among the less promiscuous, this implies 20,000 to 40,000 deaths from AIDS per year in the U.K., these estimates will be modified by behaviour changes in the population as a whole, responding to fear of infection and to health-education approaches, but substantial control will depend upon the production of a vaccine and its preferential use in the promiscuous classes.

Explore related subjects

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

E G Knox. 1986. A transmission model for AIDS.. https://doi.org/10.1007/bf00211527

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

Regression analysis of failure time data with informative interval censoring.

Interval censoring arises when a subject misses prescheduled visits at which the failure is to be assessed. Most existing approaches for analysing interval-censored failure time data assume that the censoring mechanism is independent of the true failure time. However, there are situations where this assumption may not hold. In this paper, we consider such a situation in which the dependence structure between the censoring variables and the failure time can be modelled through some latent variables and a method for regression analysis of failure time data is proposed. The method makes use of the proportional hazards frailty model and an EM algorithm is presented for estimation. Finite sample properties of the proposed estimators of regression parameters are examined through simulation studies and we illustrate the method with data from an AIDS study.

Acquired Immunodeficiency Syndrome↗

Two and a half years of routine HIV testing in Botswana.

BACKGROUND: Botswana was the first African country to introduce routine HIV testing (RHT). OBJECTIVE: To report program data for the first 2.5 years of RHT. METHODS: RHT was introduced in 2004. Rapid HIV tests were introduced later the same year and are widely available. The main criteria for RHT are symptoms of HIV/AIDS, pregnancy, sexually transmitted infection, and attendance for medical examination. Testing may also be self-initiated. FINDINGS: There has been a rapid scale-up of RHT. A total of 60,846 persons were tested through RHT in 2004 versus 157,894 in 2005 and 88,218 in the first half of 2006. Testing rates in the population through RHT were 40 per 1000 persons, 93 per 1000 persons, and 104 per 1000 persons, respectively. In 2005, 89% of those offered testing accepted, with 69% of those tested being female and 31% male. The proportion of men who tested HIV-positive was 34% versus 30% for women. The main reasons for testing in 2005 were patient's wish (50%), pregnancy (25%), medical examination (7%), clinical suspicion (6%), and sexually transmitted infection (2%). Attendance at voluntary counseling and testing centers has increased parallel to the scale-up of RHT. CONCLUSIONS: RHT has been widely accepted by the population, and no adverse effects or instances have been reported. It has provided increased access to preventive services and earlier assessment for antiretroviral treatment. We believe the benefits of RHT clearly outweigh the risks.

Acquired Immunodeficiency Syndrome↗

Risk factors for human Herpesvirus 8 infection and AIDS-associated Kaposi's sarcoma among men who have sex with men in a European multicentre study.

We aimed to identify risk factors for Kaposi's sarcoma (KS) among HIV-positive patients and behaviors associated with human Herpesvirus 8 (HHV-8) infection, as well as to assess KS incidence and mortality rates longitudinally. To fulfill the first objective, a European case-control study was designed in the early 1990s (each KS case was matched to 2 controls with another AIDS indicative disease). After the discovery of HHV-8, serology testing enabled us to assess risk factors for KS development among HHV-8 and HIV-1 coinfected men who have sex with men (MSM), as well as risk factors for HHV-8 infection. HHV-8 seroprevalence was determined using a latent immunofluorescence assay. Relevant information was obtained by means of a questionnaire and medical charts review. Assessment of risk factors for KS development and HHV-8 infection was performed using conditional and unconditional logistic regression models, respectively. A low CD4 count was the only significant risk factor for KS. HHV-8 infection was most strongly linked to the number of life-time sex partners, and multiple body fluids such as saliva and semen are quite likely involved in sexual transmission. Longitudinal follow up showed a significant protective role for highly-active antiretroviral therapy (HAART) both on KS development and mortality of KS patients. Although more conclusive data from cohort studies are needed to better define specific transmission mechanisms for HHV-8, our results contribute to explain why KS incidence is higher among MSM, and the decreasing KS incidence trend observed in countries with universal access to HAART.

Acquired Immunodeficiency Syndrome↗