Description
- Abstract:
- Background: People who inject drugs (PWID) are at high-risk for acquiring HIV in the rural United States. In 2015, Scott County, Indiana experienced the largest HIV outbreak among PWID in a rural setting in the United States. Structural characteristics of injection drug use networks are of great importance to understanding the increasing incidence of HIV in this sub-population. Methods: We used an agent-based model to simulate HIV transmission in the combined sexual and injection drug use network in Scott County, Indiana. We calibrated the model based on observed values of Scott County and a rural, injection drug use population in Kentucky. We simulated the progression of HIV through Scott County with 1,000 iterations, allowing the stochasticity of the agent-based model to drive differences in the simulated network structures. We measured ten network metrics on each network to analyze how structural network characteristics affect the cumulative number of new HIV infections. Results: The model predicted 211 cumulative incident HIV infections (95% SI: 17–306) by the end of the five-year simulation period. Our primary finding is the strong, first order effect of main connected component size on the number of cumulative incident HIV infections. We predict that with every added individual to the main connected component, the number of incident infections will increase by 0.4524. Our secondary finding also revealed that decreases in the maximum degree of HIV infected agents at t = 0, main component density, and transitivity in the main component might result in less extreme epidemic behavior. Conclusion: Network structure characteristics unique to injection-drug use networks, such as a large main component, relatively high degree distributions, high density, and presence of high amounts of transitivity, put communities of PWID at a particularly high-risk for rapid HIV transmission. Prioritizing the development of network-based intervention strategies that address these characteristics, such as creating methods to identify individuals that bridge sub-populations of the network, is imperative in supporting the health of these communities.
- Notes:
- Senior thesis (ScB)--Brown University, 2019
- Concentration: Applied Mathematics
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- Collection is open for research.
Citation
Singleton, Alyson,
"Network characteristics associated with rapid HIV transmission among people who inject drugs in a rural county in the United States: a modelling study"
(2019).
Applied Mathematics Theses and Dissertations.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/xz96-1p36
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Applied Mathematics Theses and Dissertations
Theses and Dissertations for the Applied Mathematics department....