College of Computer and Information Science, Northeastern University, Boston, Massachusetts, USA.
PLoS One. 2013 Aug 1;8(8):e64653. doi: 10.1371/journal.pone.0064653. Print 2013.
We formulated a network-based model to understand how risk behavior change in conjunction with failure of prophylactic interventions can lead to unintended outcomes where "less (intervention) is more (effective)." Our model captures the distinction between one- and two-sided risk behavior change. In one-sided situations (e.g. influenza/H1N1) it is sufficient for either individual in an interaction to exhibit risk behavior change whereas in two-sided situations (e.g. AIDS/HIV) it is necessary for both individuals in the interaction to exhibit risk behavior change, for a potential transmission of the disease. A central discovery is that this phenomenon occurs at differing levels of intervention coverage depending upon the "sidedness" of the interaction. We find that for one-sided interactions, sufficiently high vaccination coverage is necessary for mitigating the effects of risk behavior; for two-sided interactions, it is essential to combine prophylactic treatments with programs aimed at reducing risky behavior. Furthermore, again dependent on the "sidedness," targeting highly connected nodes can be strictly worse than uniformly random interventions at the same level of coverage.
我们制定了一个基于网络的模型,以了解风险行为的改变如何与预防性干预措施的失败相结合,从而导致“干预越少(有效)”的意外结果。我们的模型捕捉到了风险行为改变的单边和双边之间的区别。在单边情况下(例如流感/H1N1),交互作用中的任何一个个体表现出风险行为改变就足够了,而在双边情况下(例如艾滋病/HIV),交互作用中的两个人都必须表现出风险行为改变,才能有可能传播疾病。一个重要的发现是,这种现象在不同水平的干预措施覆盖范围内发生,这取决于交互作用的“单边性”。我们发现,对于单边交互作用,足够高的疫苗接种覆盖率对于减轻风险行为的影响是必要的;对于双边交互作用,将预防性治疗与旨在减少风险行为的计划相结合是至关重要的。此外,同样取决于“单边性”,针对高度连接的节点可能比相同覆盖水平的均匀随机干预要差得多。