Karmon Eran, Potts Malcolm, Getz Wayne M
Biophysics Group, University of California, Berkeley, 94720, USA.
J Acquir Immune Defic Syndr. 2003 Sep 1;34(1):71-5. doi: 10.1097/00126334-200309010-00011.
We present a simple mathematical model for assessing the effects of introducing a microbicide as an HIV infection protective method. As very little is known about the in vivo efficacy of microbicides, we ran sample scenarios for microbicides of various efficacies. We found that, in general, if existing condom usage in a community is low, introducing a microbicide will most likely have a positive impact on HIV incidence as abandonment of condom use in favor of microbicides will not play a significant role. If condom use in a community is high, though, attrition of condom users could play a role large enough to overwhelm any added risk reduction afforded new microbicide users. Our model illustrates the importance of knowing key behavioral parameters, such as the proportion of the population that uses condoms, before microbicides can be safely introduced. These parameters include the proportion of condom users likely to maintain condom use and the proportion of condom nonusers likely to adopt microbicides, as well as the efficacy of the candidate microbicide.
我们提出了一个简单的数学模型，用于评估引入杀微生物剂作为一种预防艾滋病毒感染方法的效果。由于对杀微生物剂的体内疗效了解甚少，我们针对各种疗效的杀微生物剂进行了抽样情景分析。我们发现，一般来说，如果一个社区中现有的避孕套使用率较低，引入杀微生物剂很可能会对艾滋病毒发病率产生积极影响，因为放弃使用避孕套而改用杀微生物剂的情况不会起到显著作用。然而，如果一个社区中避孕套使用率较高，那么避孕套使用者的流失可能会起到足够大的作用，从而抵消新使用杀微生物剂的人所带来的任何额外风险降低效果。我们的模型说明了在能够安全引入杀微生物剂之前，了解关键行为参数（如使用避孕套的人群比例）的重要性。这些参数包括可能继续使用避孕套的避孕套使用者比例、可能采用杀微生物剂的非避孕套使用者比例，以及候选杀微生物剂的疗效。
