title: Understanding the effects of different HIV transmission models in individual-based microsimulation of HIV epidemic dynamics in people who inject drugs.
abstract: We investigated how different models of HIV transmission, and assumptions regarding the distribution of unprotected sex and syringe-sharing events ('risk acts'), affect quantitative understanding of HIV transmission process in people who inject drugs (PWID). The individual-based model simulated HIV transmission in a dynamic sexual and injecting network representing New York City. We constructed four HIV transmission models: model 1, constant probabilities; model 2, random number of sexual and parenteral acts; model 3, viral load individual assigned; and model 4, two groups of partnerships (low and high risk). Overall, models with less heterogeneity were more sensitive to changes in numbers risk acts, producing HIV incidence up to four times higher than that empirically observed. Although all models overestimated HIV incidence, micro-simulations with greater heterogeneity in the HIV transmission modelling process produced more robust results and better reproduced empirical epidemic dynamics.
authors.affiliation: School of Public Health,Brown University,Providence,RI,USA.
authors.forename: J F G
authors.initials: JF
authors.lastname: Monteiro
authors.affiliation: School of Public Health,Brown University,Providence,RI,USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Escudero
authors.affiliation: School of Public Health,Brown University,Providence,RI,USA.
authors.forename: C
authors.initials: C
authors.lastname: Weinreb
authors.affiliation: Division of Infectious Diseases,The Miriam Hospital,Providence,RI,USA.
authors.forename: T
authors.initials: T
authors.lastname: Flanigan
authors.affiliation: School of Public Health,Boston University,Boston,MA,USA.
authors.forename: S
authors.initials: S
authors.lastname: Galea
authors.affiliation: Institute for Infectious Disease Research, National Development and Research Institutes Inc.,New York,NY,USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Friedman
authors.affiliation: School of Public Health,Brown University,Providence,RI,USA.
authors.forename: B D L
authors.initials: BD
authors.lastname: Marshall
mesh_terms: D000293:Adolescent; D000328:Adult; D058872:Epidemics; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009519:New York City / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications*; D047568:Unsafe Sex; D055815:Young Adult
keywords: Condom use; HIV; Monte Carlo simulation; individual-based model