台湾男男性行为者中 HIV 传播动力学：一项数学建模研究。

Dynamics of HIV transmission among men who have sex with men in Taiwan: a mathematical modeling study.

机构信息

Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Faculty of Nursing, Hiroshima International University, Kure, Japan.

出版信息

BMC Public Health. 2024 Nov 6;24(1):3063. doi: 10.1186/s12889-024-20494-w.

DOI:10.1186/s12889-024-20494-w

PMID:39506719

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11539805/

Abstract

BACKGROUND

In Taiwan, the human immunodeficiency virus (HIV) is primarily transmitted among men who have sex with men (MSM). We believe that the primary source of heterogeneity influencing transmission is from whether the infected individuals engage in behaviors that promote transmission. Therefore, we differentiated and modeled the statuses of infected individuals, estimated parameters, and predicted future infection trends to better understand HIV transmission dynamics among MSM.

METHODS

We devised a computational approach to accurately estimate the number of infectious individuals during early surveillance years in Taiwan using monthly data of newly diagnosed patients with HIV from January 2005 to December 2006. Subsequently, using annual incident cases from 2005 to 2019, we estimated the susceptibility rate, transmission rates, and duration of risk and conducted short-term forecasts of HIV infection among MSM through mathematical modeling based on the susceptible-infected-removed model. Parameters and their values, such as HIV and acquired immunodeficiency syndrome (AIDS) transmission rates and removal rates, were also estimated.

RESULTS

A total of 850 infectious individuals with HIV were identified in 2005. From 2005 to 2019, approximately 0.68% (95% confidence interval: 0.64-0.71%) of Taiwan's male population were estimated to be susceptible to HIV infection via MSM. The transmission rate did not significantly differ between individuals with HIV and AIDS (0.0110 and 0.107 per 10,000 individuals, respectively). The average infection duration between infection and AIDS onset was 4.5 years and between AIDS onset and death was 2.1 years. In 2019, the proportion of infectious infected individuals continuously decreased. By 2026, only 11.85% and 10.21% of individuals with HIV and AIDS, respectively, will be infectious.

CONCLUSIONS

Our study presents a new dynamic mathematical model for estimating infectious HIV cases among MSM in Taiwan. By accounting for the heterogeneity of infectious HIV/AIDS within the MSM population, we effectively estimated the number of infections during early surveillance years and implement concentrated measures, thereby reducing infectious HIV/AIDS cases, which contributes to the overall reduction in HIV/AIDS cases. With these estimations, identifying target populations and implementing effective intervention measures at appropriate times can be improved.

摘要

背景

在台湾，人类免疫缺陷病毒（HIV）主要通过男男性行为者（MSM）传播。我们认为，影响传播的异质性的主要来源是感染个体是否从事促进传播的行为。因此，我们对感染者的状态进行区分和建模，估计参数，并预测未来的感染趋势，以更好地了解 MSM 中的 HIV 传播动态。

方法

我们设计了一种计算方法，使用 2005 年 1 月至 2006 年 12 月期间新诊断 HIV 患者的每月数据，准确估计台湾早期监测年度期间的感染人数。随后，使用 2005 年至 2019 年的年度发病病例，我们根据易感染-感染-清除模型，通过数学建模估计易感性率、传播率和风险持续时间，并对 MSM 中的 HIV 感染进行短期预测。还估计了 HIV 和获得性免疫缺陷综合征（AIDS）传播率和清除率等参数及其值。

结果

2005 年共发现 850 例 HIV 感染个体。2005 年至 2019 年，估计台湾男性人口中约有 0.68%（95%置信区间：0.64-0.71%）易受 HIV 通过 MSM 感染。HIV 和 AIDS 个体的传播率没有显著差异（分别为每 10,000 人 0.0110 和 0.107）。感染和 AIDS 发病之间的平均感染持续时间为 4.5 年，AIDS 发病和死亡之间的平均感染持续时间为 2.1 年。2019 年，感染个体的比例持续下降。到 2026 年，HIV 和 AIDS 感染者中分别只有 11.85%和 10.21%具有传染性。

结论

我们的研究提出了一种新的动态数学模型，用于估计台湾 MSM 中 HIV 感染者的传染性病例。通过考虑 MSM 人群中 HIV/AIDS 感染者的异质性，我们有效估计了早期监测年度的感染人数，并实施了集中措施，从而减少了传染性 HIV/AIDS 病例，有助于整体减少 HIV/AIDS 病例。通过这些估计，可以在适当的时候确定目标人群并实施有效的干预措施。