Literature DB >> 26102448

A Data-Driven Simulation of HIV Spread Among Young Men Who Have Sex With Men: Role of Age and Race Mixing and STIs.

Ekkehard C Beck1, Michelle Birkett, Benjamin Armbruster, Brian Mustanski.   

Abstract

OBJECTIVE: Young men who have sex with men (YMSM) in the United States have a high HIV incidence with substantial racial disparities that are poorly understood. We use a data-driven simulation model to understand the impact of network-level mechanisms and sexually transmitted infections on the spread of HIV among YMSM.
METHODS: We designed and parameterized a stochastic agent-based network simulation model using results of a longitudinal cohort study of YMSM in Chicago. Within this model, YMSM formed and dissolved partnerships over time, and partnership types were stratified by length of partnership, sex, and age of the partner. In each partnership, HIV, gonorrhea, and chlamydia could be transmitted. Counterfactual scenarios were run to examine drivers of HIV.
RESULTS: Over a 15-year simulation, the HIV epidemic among YMSM continued to rise, with Latino/white YMSM facing a steeper increase in the HIV burden compared with black YMSM. YMSM in partnerships with older MSM, in particular black YMSM with older black MSM, were at highest risk for HIV, and 1 infection prevented with an older partner would prevent 0.8 additional infections among YMSM. Additionally, racial disparities in HIV were driven by differences in the HIV prevalence of YMSM partners. Finally, of all HIV infections among YMSM, 14.6% were attributable to NG and CT infections.
CONCLUSION: Network-level mechanisms and sexually transmitted infections play a significant role in the spread of HIV and in racial disparities among YMSM. HIV prevention efforts should target YMSM across race, and interventions focusing on YMSM partnerships with older MSM might be highly effective.

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Year:  2015        PMID: 26102448      PMCID: PMC4573360          DOI: 10.1097/QAI.0000000000000733

Source DB:  PubMed          Journal:  J Acquir Immune Defic Syndr        ISSN: 1525-4135            Impact factor:   3.731


  41 in total

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