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. 1998 Oct;74(5):339–344. doi: 10.1136/sti.74.5.339

Heterosexual HIV transmission and STD prevalence: predictions of a theoretical model

A M Renton, L Whitaker, M Riddlesdell
PMCID: PMC1758149  PMID: 10195029

Abstract

BACKGROUND: Previous studies suggest that concurrent sexually transmitted infection may enhance HIV transmission. This paper explores some theoretical consequences of this using a mathematical model of transmission of HIV and other STD pathogens. OBJECTIVES: To develop a deterministic mathematical model to describe the heterosexual transmission dynamics of both HIV and a bacterial STD. STUDY DESIGN: We used survey derived estimates of sexual behaviour in a young heterosexual London population in our deterministic mathematical model to estimate the effects on an HIV epidemic of different levels of STD prevalence in such a population. RESULTS: We show that the predictions of the model are plausible and suggest that, even under conditions both of low STD prevalence and of low HIV transmission enhancement, a substantial proportion of HIV transmission events may be attributable to concurrent STD. CONCLUSIONS: It is likely that epidemics of heterosexually transmitted HIV infection in industrialised countries have been limited in size by the relative success of efforts to control STD. None the less, a significant proportion of heterosexual transmission events which do occur may be attributable to concurrent STD. In developing countries, cheap and simple STD care is likely to be a highly cost effective strategy to prevent HIV transmission. 




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Selected References

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  1. Anderson D. J., O'Brien T. R., Politch J. A., Martinez A., Seage G. R., 3rd, Padian N., Horsburgh C. R., Jr, Mayer K. H. Effects of disease stage and zidovudine therapy on the detection of human immunodeficiency virus type 1 in semen. JAMA. 1992 May 27;267(20):2769–2774. [PubMed] [Google Scholar]
  2. Anderson R. M. Mathematical and statistical studies of the epidemiology of HIV. AIDS. 1989 Jun;3(6):333–346. doi: 10.1097/00002030-198906000-00001. [DOI] [PubMed] [Google Scholar]
  3. Anderson R. M., May R. M. Epidemiological parameters of HIV transmission. Nature. 1988 Jun 9;333(6173):514–519. doi: 10.1038/333514a0. [DOI] [PubMed] [Google Scholar]
  4. Clemetson D. B., Moss G. B., Willerford D. M., Hensel M., Emonyi W., Holmes K. K., Plummer F., Ndinya-Achola J., Roberts P. L., Hillier S. Detection of HIV DNA in cervical and vaginal secretions. Prevalence and correlates among women in Nairobi, Kenya. JAMA. 1993 Jun 9;269(22):2860–2864. [PubMed] [Google Scholar]
  5. De Schryver A., Meheus A. Epidemiology of sexually transmitted diseases: the global picture. Bull World Health Organ. 1990;68(5):639–654. [PMC free article] [PubMed] [Google Scholar]
  6. Dietz K., Hadeler K. P. Epidemiological models for sexually transmitted diseases. J Math Biol. 1988;26(1):1–25. doi: 10.1007/BF00280169. [DOI] [PubMed] [Google Scholar]
  7. Fish A. N., Fairweather D. V., Oriel J. D., Ridgway G. L. Chlamydia trachomatis infection in a gynaecology clinic population: identification of high-risk groups and the value of contact tracing. Eur J Obstet Gynecol Reprod Biol. 1989 Apr;31(1):67–74. doi: 10.1016/0028-2243(89)90027-0. [DOI] [PubMed] [Google Scholar]
  8. Garnett G. P., Anderson R. M. Contact tracing and the estimation of sexual mixing patterns: the epidemiology of gonococcal infections. Sex Transm Dis. 1993 Jul-Aug;20(4):181–191. doi: 10.1097/00007435-199307000-00001. [DOI] [PubMed] [Google Scholar]
  9. Grosskurth H., Mosha F., Todd J., Mwijarubi E., Klokke A., Senkoro K., Mayaud P., Changalucha J., Nicoll A., ka-Gina G. Impact of improved treatment of sexually transmitted diseases on HIV infection in rural Tanzania: randomised controlled trial. Lancet. 1995 Aug 26;346(8974):530–536. doi: 10.1016/s0140-6736(95)91380-7. [DOI] [PubMed] [Google Scholar]
  10. Kiviat N. B., Paavonen J. A., Wølner-Hanssen P., Critchlow C. W., Stamm W. E., Douglas J., Eschenbach D. A., Corey L. A., Holmes K. K. Histopathology of endocervical infection caused by Chlamydia trachomatis, herpes simplex virus, Trichomonas vaginalis, and Neisseria gonorrhoeae. Hum Pathol. 1990 Aug;21(8):831–837. doi: 10.1016/0046-8177(90)90052-7. [DOI] [PubMed] [Google Scholar]
  11. Kreiss J., Caraël M., Meheus A. Role of sexually transmitted diseases in transmitting human immunodeficiency virus. Genitourin Med. 1988 Feb;64(1):1–2. doi: 10.1136/sti.64.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Laga M., Manoka A., Kivuvu M., Malele B., Tuliza M., Nzila N., Goeman J., Behets F., Batter V., Alary M. Non-ulcerative sexually transmitted diseases as risk factors for HIV-1 transmission in women: results from a cohort study. AIDS. 1993 Jan;7(1):95–102. doi: 10.1097/00002030-199301000-00015. [DOI] [PubMed] [Google Scholar]
  13. Laga M. STD control for HIV prevention--it works! Lancet. 1995 Aug 26;346(8974):518–519. doi: 10.1016/s0140-6736(95)91374-2. [DOI] [PubMed] [Google Scholar]
  14. Mertens T. E., Hayes R. J., Smith P. G. Epidemiological methods to study the interaction between HIV infection and other sexually transmitted diseases. AIDS. 1990 Jan;4(1):57–65. doi: 10.1097/00002030-199001000-00008. [DOI] [PubMed] [Google Scholar]
  15. Morris M. Telling tails explain the discrepancy in sexual partner reports. Nature. 1993 Sep 30;365(6445):437–440. doi: 10.1038/365437a0. [DOI] [PubMed] [Google Scholar]
  16. Nicolosi A., Musicco M., Saracco A., Lazzarin A. Risk factors for woman-to-man sexual transmission of the human immunodeficiency virus. Italian Study Group on HIV Heterosexual Transmission. J Acquir Immune Defic Syndr. 1994 Mar;7(3):296–300. [PubMed] [Google Scholar]
  17. Peterman T. A., Stoneburner R. L., Allen J. R., Jaffe H. W., Curran J. W. Risk of human immunodeficiency virus transmission from heterosexual adults with transfusion-associated infections. JAMA. 1988 Jan 1;259(1):55–58. [PubMed] [Google Scholar]
  18. Renton A., Whitaker L., Ison C., Wadsworth J., Harris J. R. Estimating the sexual mixing patterns in the general population from those in people acquiring gonorrhoea infection: theoretical foundation and empirical findings. J Epidemiol Community Health. 1995 Apr;49(2):205–213. doi: 10.1136/jech.49.2.205. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ridgway G. L., Mumtaz G., Oriel J. D., Iriel J. D. Therapeutic abortion and chlamydial infection. Br Med J (Clin Res Ed) 1983 May 7;286(6376):1478–1479. doi: 10.1136/bmj.286.6376.1478-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Robinson N. J., Mulder D. W., Auvert B., Hayes R. J. Modelling the impact of alternative HIV intervention strategies in rural Uganda. AIDS. 1995 Nov;9(11):1263–1270. doi: 10.1097/00002030-199511000-00008. [DOI] [PubMed] [Google Scholar]
  21. Saracco A., Musicco M., Nicolosi A., Angarano G., Arici C., Gavazzeni G., Costigliola P., Gafa S., Gervasoni C., Luzzati R. Man-to-woman sexual transmission of HIV: longitudinal study of 343 steady partners of infected men. J Acquir Immune Defic Syndr. 1993 May;6(5):497–502. [PubMed] [Google Scholar]
  22. Southgate L. J., Treharne J. D., Forsey T. Chlamydia trachomatis and Neisseria gonorrhoeae infections in women attending inner city general practices. Br Med J (Clin Res Ed) 1983 Sep 24;287(6396):879–881. doi: 10.1136/bmj.287.6396.879. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Swinton J., Garnett G. P., Brunham R. C., Anderson R. M. Gonococcal infection, infertility, and population growth: I. Endemic states in behaviourally homogeneous growing populations. IMA J Math Appl Med Biol. 1992;9(2):107–126. doi: 10.1093/imammb/9.2.107. [DOI] [PubMed] [Google Scholar]
  24. Telzak E. E., Chiasson M. A., Bevier P. J., Stoneburner R. L., Castro K. G., Jaffe H. W. HIV-1 seroconversion in patients with and without genital ulcer disease. A prospective study. Ann Intern Med. 1993 Dec 15;119(12):1181–1186. doi: 10.7326/0003-4819-119-12-199312150-00005. [DOI] [PubMed] [Google Scholar]
  25. Van de Perre P., De Clercq A., Cogniaux-Leclerc J., Nzaramba D., Butzler J. P., Sprecher-Goldberger S. Detection of HIV p17 antigen in lymphocytes but not epithelial cells from cervicovaginal secretions of women seropositive for HIV: implications for heterosexual transmission of the virus. Genitourin Med. 1988 Feb;64(1):30–33. doi: 10.1136/sti.64.1.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Watts C. H., May R. M. The influence of concurrent partnerships on the dynamics of HIV/AIDS. Math Biosci. 1992 Feb;108(1):89–104. doi: 10.1016/0025-5564(92)90006-i. [DOI] [PubMed] [Google Scholar]
  27. Wolff H., Anderson D. J. Male genital tract inflammation associated with increased numbers of potential human immunodeficiency virus host cells in semen. Andrologia. 1988 Sep-Oct;20(5):404–410. [PubMed] [Google Scholar]
  28. de Vincenzi I. A longitudinal study of human immunodeficiency virus transmission by heterosexual partners. European Study Group on Heterosexual Transmission of HIV. N Engl J Med. 1994 Aug 11;331(6):341–346. doi: 10.1056/NEJM199408113310601. [DOI] [PubMed] [Google Scholar]

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