Type of partnership and heterosexual spread of HIV infection in rural Uganda: results from simulation modelling.
The objective was to estimate the likely percentage of HIV infections that may be attributable to one-off partnerships (such as those between female sex workers and their clients) and longer-term partnerships in rural Uganda. This was addressed by the application of a microsimulation model (SimulAIDS) of the transmission dynamics of HIV infection, drawing on data from a population cohort of 10,000 in rural Uganda. For a scenario reproducing documented characteristics of the study population in 1990, when adult HIV prevalence was 9%, and during subsequent follow up (1990-1994), when adult HIV incidence was 8 per 1000 person-years, the percentage of HIV infections in men (women) attributed to one-off partnerships decreased from 96% (26%) during 1980 to 67% (8%) in 1989 and 22% (5%) in 1994. Reducing HIV transmission between one-off partners early in an HIV epidemic may substantially limit the potential for the spread of HIV infection. At a later phase, prevention must also focus on control of transmission between longer-term HIV-discordant partners.
Robinson
N J
NJ
INSERM Unit 88, Saint-Maurice, France. jnr86737@glaxowellcome.co.uk
Mulder
D
D
Auvert
B
B
Whitworth
J
J
Hayes
R
R
D000328:Adult; D002648:Child; D015331:Cohort Studies; D003198:Computer Simulation; D004196:Disease Outbreaks; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission*; D006801:Humans; D015994:Incidence; D008017:Life Expectancy; D008297:Male; D008954:Models, Biological; D015995:Prevalence; D012424:Rural Population; D012725:Sexual Behavior; D012747:Sexual Partners / Q000145:classification*; D014454:Uganda / Q000453:epidemiology