Measuring concurrency using a joint multistate and point process model for retrospective sexual history data.
Measuring concurrency using a joint multistate and point process model for retrospective sexual history data.
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DOI：
10.1002/sim.7013
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发表时间：
2016-10-30
影响因子：
2
通讯作者：
Brookmeyer, Ron
中科院分区：
文献类型：
--
作者：
Aralis, Hilary J.;Gorbach, Pamina M.;Brookmeyer, Ron
由于难以衡量同时发生的性行为，因此难以理解同时发生的性行为（即重叠的性伙伴关系）对艾滋病毒在不同社区内传播的影响。回顾性的性史数据，包括第一次和最后一次性交的日期，为每一个以前和正在进行的伙伴关系，往往是通过使用横断面调查。以前试图从经验上估计这些被调查人群中并发的规模和程度，但没有充分考虑到伙伴关系之间的依赖性，只使用了现有数据的快照。我们引入了一个联合的多状态和点过程模型，其中状态被定义为一个人在给定时间正在进行的伙伴关系的数量。在同一天开始和结束的性伴侣关系被称为一次性事件，并被建模为离散事件。所提出的方法对待每个人的继续和过渡，通过各种数量的正在进行的伙伴关系作为一个单独的随机过程，并允许一次性的发生，以影响随后的合作伙伴关系的形成和解散率。估计并发的伙伴关系分布和平均逗留时间，在此期间，一个人有k个正在进行的伙伴关系。我们证明了这种建模方法，使用流行病学数据收集的样本，男性与男性发生性关系，并寻求艾滋病毒检测在洛杉矶诊所。在这一样本中，估计并发症的点流行率在后来被诊断为艾滋病毒阳性的男性中较高。一次性与随后的伙伴关系解散率增加。
Understanding the impact of concurrency, defined as overlapping sexual partnerships, on the spread of HIV within various communities has been complicated by difficulties in measuring concurrency. Retrospective sexual history data consisting of first and last dates of sexual intercourse for each previous and ongoing partnership is often obtained through use of cross-sectional surveys. Previous attempts to empirically estimate the magnitude and extent of concurrency among these surveyed populations have inadequately accounted for the dependence between partnerships and used only a snapshot of the available data. We introduce a joint multistate and point process model in which states are defined as the number of ongoing partnerships an individual is engaged in at a given time. Sexual partnerships starting and ending on the same date are referred to as one-offs and modeled as discrete events. The proposed method treats each individual’s continuation in and transition through various numbers of ongoing partnerships as a separate stochastic process and allows the occurrence of one-offs to impact subsequent rates of partnership formation and dissolution. Estimators for the concurrent partnership distribution and mean sojourn times during which a person has k ongoing partnerships are presented. We demonstrate this modeling approach using epidemiological data collected from a sample of men having sex with men and seeking HIV testing at a Los Angeles clinic. Among this sample, the estimated point prevalence of concurrency was higher among men later diagnosed HIV positive. One-offs were associated with increased rates of subsequent partnership dissolution.
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