HIV transmission from drug injectors to partners who do not inject, and beyond: modelling the potential for a generalized heterosexual epidemic in St. Petersburg, Russia.
HIV transmission from drug injectors to partners who do not inject, and beyond: modelling the potential for a generalized heterosexual epidemic in St. Petersburg, Russia.
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DOI：
10.1016/j.drugalcdep.2013.04.028
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发表时间：
2013-11-01
影响因子：
4.2
通讯作者：
Heimer R
中科院分区：
文献类型：
--
作者：
Mills HL;White E;Colijn C;Vickerman P;Heimer R
艾滋病毒感染在彼得堡的吸毒者及其非注射异性伴侣（PIDU）中普遍存在。人们担心，艾滋病毒从注射吸毒者到非注射吸毒者的性传播可能预示着俄罗斯会出现一种自我维持的异性恋流行病。我们的模型结合了网络模型的性伙伴关系的注射吸毒者和非注射吸毒者代表性传播的艾滋病毒和注射吸毒者之间的胃肠外传播的确定性模型。从对彼得堡注射吸毒者及其性伴侣的调查中获得行为参数。我们的模型基于2006年PIDU患病率的两种情况（5.6%和15.1%，分别计算不包括和包括HCV合并感染的PIDU），并比较了对一般人群HIV患病率的预测。结果表明，性传播可以维持非注射吸毒者的艾滋病毒流行。该模型表明，一般人群的流行率可能高于目前的估计数。肠胃外传播是该流行病的主要原因，而非注射吸毒者过渡人群在将感染传播给非注射吸毒者方面起着至关重要的作用。该模型表明，PIDU的高患病率是不可能的，因为这意味着高风险行为;较低的患病率是可能的。该模型意味着，如果注射吸毒者和非吸毒者中的流行率与调查数据所显示的一样高，通过非吸毒者的传播将维持异性恋流行。我们认为，目前对人口流行率的估计低估了艾滋病毒流行的程度，因为这些估计仅以登记的病例数为基础。减少注射者和PIDUs之间的传播对于控制异性性传播至关重要。
HIV infection is prevalent among drug injectors in St. Petersburg and their non-injecting heterosexual partners (PIDUs). There are fears that sexual transmission of HIV from IDUs to PIDUs may portend a self-sustaining, heterosexual epidemic in Russia. Our model combines a network model of sexual partnerships of IDUs and non-IDUs to represent sexual transmission of HIV and a deterministic model for parenteral transmission among IDUs. Behavioural parameters were obtained from a survey of St. Petersburg IDUs and their sexual partners. We based our model fits on two scenarios for PIDU prevalence in 2006 (5.6% and 15.1%, calculated excluding and including HCV co-infected PIDUs respectively) and compared predictions for the general population HIV prevalence. Results indicate that sexual transmission could sustain a non-IDU HIV epidemic. The model indicates that general population prevalence may be greater than current estimates imply. Parenteral transmission drives the epidemic and the PIDU bridge population plays a crucial role transferring infection to non-IDUs. The model indicates that the high PIDU prevalence is improbable because of the high risk behaviour this implies; the lower prevalence is possible. The model implies that transmission through PIDUs will sustain a heterosexual epidemic, if prevalence among IDUs and PIDUs is as high as survey data suggest. We postulate that current estimates of population prevalence underestimate the extent of the HIV epidemic because they are based on the number of registered cases only. Curtailing transmission among injectors and PIDUs will be vital in controlling heterosexual transmission.
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影响因子：
1.4
作者：
Abdala, N;Carney, JM;Heimer, R
通讯作者：
Heimer, R
影响因子：
4.4
作者：
Grau, Lauretta E.;White, Edward;Heimer, Robert
通讯作者：
Heimer, Robert
影响因子：
4.4
作者：
Lowndes, C. M.;Renton, A.;Stimson, G.
通讯作者：
Stimson, G.
影响因子：
4.2
作者：
Heimer, Robert;White, Edward
通讯作者：
White, Edward
影响因子：
5.4
作者：
Aral, SO;Lawrence, JSS;Kozlov, A
通讯作者：
Kozlov, A