RTI International, Durham, North Carolina, United States of America.
North Carolina State University, Raleigh, North Carolina, United States of America.
PLoS One. 2014 May 19;9(5):e94799. doi: 10.1371/journal.pone.0094799. eCollection 2014.
A number of factors have been identified that are related to sexual and injecting HIV transmission. We developed a probabilistic mathematical model to put these factors together and interpret risks in the context of individual behavior among injecting drug-using (IDU) couples in St. Petersburg, Russia. Some HIV-discordant couples have unprotected sex and sometimes inject drugs together but stay discordant for a long time, while some individuals acquire HIV on the first encounter. We considered existing estimates of HIV transmission risks through injecting and sexual contacts to develop a predictive survival model for an individual who is exposed to HIV through intimate relationships. We computed simulated survival curves for a number of behavioral scenarios and discussed sources of simulated uncertainty. We then applied the model to a longitudinal study of HIV-discordant couples and validated the model's forecast. Although individual prediction of seroconversion time appeared impossible, the ability to rank behavioral patterns in terms of HIV risk and to estimate the probability of survival HIV-free will be important to educators and counselors.
已经确定了一些与性传播和注射途径 HIV 传播相关的因素。我们开发了一个概率数学模型，将这些因素结合起来，并在俄罗斯圣彼得堡注射吸毒者（IDU）夫妇的个体行为背景下解释风险。一些 HIV 不一致的夫妇会进行无保护的性行为，有时还会一起注射毒品，但长时间保持不一致，而一些人则在第一次接触时就感染了 HIV。我们考虑了通过注射和性接触传播 HIV 的现有风险估计，以开发一种针对通过亲密关系接触 HIV 的个体的预测生存模型。我们为许多行为场景计算了模拟生存曲线，并讨论了模拟不确定性的来源。然后，我们将模型应用于对 HIV 不一致的夫妇的纵向研究，并验证了模型的预测。尽管对血清转换时间进行个体预测似乎是不可能的，但根据 HIV 风险对行为模式进行排序以及估计无 HIV 生存的概率的能力对于教育者和顾问来说将非常重要。
