AEGiS-14IAC: Modelling emerging HIV epidemics.

14th International AIDS Conference

Barcelona, Spain - July 7-12, 2002

Modelling emerging HIV epidemics.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. TuOrC1220b)

Grassly NC, Rhodes T, Lowndes CM, Renton AM, Garnett GP
Imperial College Faculty of Medicine, London, United Kingdom

BACKGROUND: The course of the HIV pandemic over the next decade will be determined by the emerging epidemics in India, China, Eastern Europe and Central Asia. Commercial sex work and injecting drug use (IDU) in these countries have resulted in high prevalence of HIV among high risk groups, but more generalised sexual transmission has so far been restricted. The role of commercial sex, IDU and the overlap of these behaviours in determining the emergence of generalised HIV epidemics is explored using a mathematical model.

METHODS: A model of HIV transmission by IDU and sex is described, and its dynamics explored using sensitivity analysis based on behavioural data collected in Russia and biological parameters collected via a literature review.

RESULTS: The observed overlap between commercial sex and IDU results in rapid HIV transmission and saturation among high risk groups. Subsequent generalised sexual transmission can be fuelled by these high risk groups, although sexual mixing between high and low risk groups will determine the extent of the epidemic. Projecting the course of emerging epidemics remains uncertain due to a lack of quantitative behavioural data.

CONCLUSIONS: There is an urgent need for improved seroprevalence and behavioural surveillance in Eastern Europe and Asia to improve projections of the future course of the HIV pandemic and to guide the allocation of resources.

Keywords: AEGIS, HIV Infections, Disease Outbreaks, Prevalence, HIV Seropositivity, Prostitution, Seroepidemiologic Studies, Europe, Eastern, Russia, China, Asia, India, Asia, Central, epidemiology

020707
TuOrC1220b