AEGiS-14IAC: Modelling the spread of HIV infection in four cities of sub-Saharan Africa.

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Modelling the spread of HIV infection in four cities of sub-Saharan Africa.

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrC1310)

Auvert B, Ferry B
Inserm U88, Saint Maurice, France

Backgrounds: The rate of spread of HIV is heterogeneous in sub-Sahran Africa. HIV prevalence among the general population varies from less than 2% to more than 30%. This heterogeneity is not yet understood. The multicenter study carried out in four African cities has provided new epidemiological information. The objective of the current study was to use these new data to identify the potential mechanism(s) responsible for this heterogeneity.

METHODS: A stochastic simulation model (Simul-AIDS) was used. This model allowed a detail description of demographic features, sexual behavior and a generic STI. In this model male circumcision reduced the female to male transmission of HIV and of the generic STI. HIV transmission was facilitated by the presence of the generic STI. In a first analysis, factors having an strong impact on the spread of HIV were identified. In a second analysis, numerical values for these factors were chosen accordingly to the data of the multicenter study.

RESULTS: Heterogeneity in rate of spread of HIV was obtained by varying independently sexual behavior, probability of sexual transmission of the generic STI or of HIV. When using data from the multicenter study, male circumcision (MC) was the only factor able to reproduce the heterogeneous rate of spread of HIV. In particular, the model was able to reproduce the situation of Yaounde (Cameroon) where the sexual activity is higher and the HIV spread is lower than in Kisumu (Kenya) and in Ndola (Zambia). The model was also able to reproduce explosive epidemic in situation where the men are not circumcised.

CONCLUSIONS: Modelling of the spread of HIV in sub-Saharan Africa should carefully take into account the factors other than sexual behavior and sexual mixing in order to reproduce the reality. The interaction between male circumcision, other STIs and HIV is an important mechanism to understand the spread of HIV in sub-Saharan Africa.

Keywords: AEGIS, HIV Infections, Prevalence, Sex Behavior, Circumcision, HIV Seropositivity, Cities, Africa South of the Sahara, Acquired Immunodeficiency Syndrome, Disease Outbreaks, Africa, Cameroon, Zambia, Kenya, Human, Male, Female, surgeryKWDaegis,hivinfections,prevalence,sexbehavior,circumcision,hivseropositivity,cities,africasouthofthesahara,acquiredimmunodeficiencysyndrome,diseaseoutbreaks,africa,cameroon,zambia,kenya,human,male,female,surgery

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WeOrC1310

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.