Wallace R
Epidemiology of Mental Disorders Research Department, New York State Psychiatric Institute, NY 10032.
Soc Sci Med. 1991;33(10):1155-62. doi: 10.1016/0277-9536(91)90231-z.
Previous work on the asymptotic spread of HIV infection along a low dimensional 'sociogeographic' network--a social network characteristically embedded within a limited geographic area--is extended to explore threshold conditions under which the infection extends widely beyond an initial set of infected individuals or communities. Results for one dimension suggest that threshold behavior is analogous to a chain reaction with criticality determined conjointly by the susceptibility of individuals within a community to a nexus of behavior conducive to rapid HIV spread and by the probability of transmission between susceptible communities. Once threshold is exceeded, a stochastic reformulation finds the asymptotic rate of transmission between communities may be markedly raised by positive correlation between susceptibility to rapid disease spread within a community and the transmissibility between communities, for example outmigration driven by social disintegration or residential instability arising from inherent structural factors associated with community susceptibility, as with male prostitution. Examination of threshold conditions for higher dimensional sociogeographic networks most likely characteristic of disease spread beyond the 'deep ghettos' now suffering the highest burden of infection suggests it is at least as, and likely more, effective to decrease the fraction of population susceptible to the high risk behavioral nexus as it is to lower the probability of disease transmission between susceptible individuals or communities.(ABSTRACT TRUNCATED AT 250 WORDS)
先前关于艾滋病毒感染在低维“社会地理”网络(一种典型地嵌入有限地理区域内的社会网络)上渐近传播的研究得到扩展,以探索感染在何种阈值条件下会广泛传播至初始感染个体或社区之外。一维情况的结果表明,阈值行为类似于连锁反应,其临界状态由社区内个体对有利于艾滋病毒快速传播的行为关联的易感性以及易感社区之间的传播概率共同决定。一旦超过阈值,一种随机重构发现,例如由社会解体导致的外迁或与社区易感性相关的固有结构因素引起的居住不稳定(如男妓情况),使得社区内对快速疾病传播的易感性与社区间传播性之间的正相关可能会显著提高社区间的渐近传播速率。对更高维社会地理网络阈值条件的研究(这很可能是疾病传播超出目前感染负担最重的“贫民区”的特征)表明,降低易受高风险行为关联影响的人群比例,至少与降低易感个体或社区之间的疾病传播概率同样有效,甚至可能更有效。(摘要截选于250字)