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MODELING THE EXPANSION OF THE HIV EPIDEMIC IN ST. PETERSBURG, RF

https://doi.org/10.22328/2077-9828-2014-6-1-59-65

Abstract

The high prevalence of HIV infection and substantial rates of unprotected sexual intercourse reported among injection drug users in St. Petersburg has led to speculation that sexual transmission of HIV from IDUs to their non-injecting heterosexual partners (PIDUs) may generate a self-sustaining, heterosexual epidemic. We constructed a mathematical model that incorporated behavioral data from a survey of St. Petersburg IDUs and their sexual partners into an epidemic model that combines a network model of sexual partnerships of IDUs and non-IDUs to represent sexual transmission of HIV and a deterministic model for parenteral transmission among IDUs. We compared the model to surveillance data obtained from testing conducted throughout St. Petersburg and from targeted testing of IDUs. The model closely follows both forms of surveillance. The model outputs reveal a constant HIV prevalence of approximately 50% among IDUs, increasing prevalence among PIDUs and the general population reaching 14% and 2%, respectively, by 2025. These high HIV prevalences outside of IDUs occur because parenteral transmission drives the epidemic and the PIDU bridge population plays a crucial role transferring infection into the general population. This implies that sexual transmission could sustain a non-IDU HIV epidemic but only if parenteral trans mission remains unchecked. Thus, the key to epidemic control is reducing transmission among IDUs by a combination of prevention programs and antiretroviral treatment to reduce viral load.

About the Authors

Robert Heimer
Yale School of Public Health and Center for Interdisciplinary Research on AIDS
Russian Federation


Harriet L. Mills
Imperial College London
Russian Federation


Edward White
Yale School of Public Health and Center for Interdisciplinary Research on AIDS
Russian Federation


Peter Vickerman
Imperial College London
Russian Federation


Carolyn Colijn
London School of Hygiene and Tropical Medicine
Russian Federation


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For citations:


Heimer R., Mills H.L., White E., Vickerman P., Colijn C. MODELING THE EXPANSION OF THE HIV EPIDEMIC IN ST. PETERSBURG, RF. HIV Infection and Immunosuppressive Disorders. 2014;6(1):59-65. (In Russ.) https://doi.org/10.22328/2077-9828-2014-6-1-59-65

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