title: The Interaction of Risk Network Structures and Virus Natural History in the Non-spreading of HIV Among People Who Inject Drugs in the Early Stages of the Epidemic.
abstract: This article explores how social network dynamics may have reduced the spread of HIV-1 infection among people who inject drugs during the early years of the epidemic. Stochastic, discrete event, agent-based simulations are used to test whether a "firewall effect" can arise out of self-organizing processes at the actor level, and whether such an effect can account for stable HIV prevalence rates below population saturation. Repeated simulation experiments show that, in the presence of recurring, acute, and highly infectious outbreaks, micro-network structures combine with the HIV virus's natural history to reduce the spread of the disease. These results indicate that network factors likely played a significant role in the prevention of HIV infection within injection risk networks during periods of peak prevalence. They also suggest that social forces that disturb network connections may diminish the natural firewall effect and result in higher rates of HIV.
authors.affiliation: Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE, 68588, USA. kdombrowski2@unl.edu.
authors.forename: Kirk
authors.identifier: http://orcid.org/0000-0002-9185-0240
authors.initials: K
authors.lastname: Dombrowski
authors.affiliation: Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE, 68588, USA.
authors.forename: Bilal
authors.initials: B
authors.lastname: Khan
authors.affiliation: Department of Sociology, University of Nebraska-Lincoln, 711 Oldfather Hall, Lincoln, NE, 68588, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Habecker
authors.affiliation: College of Nursing, New York University, New York, NY, USA.
authors.forename: Holly
authors.initials: H
authors.lastname: Hagan
authors.affiliation: National Development Research Institute, New York, NY, USA.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Friedman
authors.affiliation: Microjan Inc, Waterloo, ON, Canada.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Saad
mesh_terms: D000293:Adolescent; D000328:Adult; D003198:Computer Simulation; D058872:Epidemics / Q000517:prevention & control* / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology / Q000635:transmission*; D015497:HIV-1; D006801:Humans; D008297:Male; D015995:Prevalence; D011640:Public Policy; D018570:Risk Assessment / Q000706:statistics & numerical data; D012933:Social Identification; D012944:Social Support; D013269:Stochastic Processes; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult
keywords: Firewall effect; PWID; Risk networks; Simulation