Modeling the potential impact of rectal microbicides to reduce HIV transmission in bathhouses

Romulus Breban; Ian McGowan; Chad Topaz; Elissa J. Schwartz; Peter Anton; Sally Blower

doi:10.3934/mbe.2006.3.459

Article Contents

2006, Volume 3, Issue 3: 459-466. Doi: 10.3934/mbe.2006.3.459

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Modeling the potential impact of rectal microbicides to reduce HIV transmission in bathhouses

1.
Department of Biomathematics, David Ge®en School of Medicine at UCLA, Los Angeles, California, 90024
2.
Center for HIV and Digestive Diseases, Division of Digestive Diseases, The UCLA AIDS Institute, David Ge®en School of Medicine at UCLA, Los Angeles, California, 90020
3.
Department of Mathematics, UCLA, Los Angeles, California, 90020
4.
Department of Biomathematics and Department of Biostatistics, David Geffen School of Medicine at UCLA, Los Angeles, California, 90020
5.
Center for HIV and Digestive Diseases, Division of Digestive Diseases, The UCLA AIDS Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, 90020
6.
Department of Biomathematics & the UCLA AIDS Institute, David Geffen School of Medicine at UCLA, Los Angeles, California, 90024

Received: March 2005

Revised: January 2006

Published: May 2006

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Abstract

We evaluate the potential impact of rectal microbicides for reducing HIV transmission in bathhouses. A new mathematical model describing HIV transmission dynamics among men who have sex with men (MSM) in bathhouses is constructed and analyzed. The model incorporates key features affecting transmission, including sexual role behavior (insertive and receptive anal intercourse acts), biological transmissibility of HIV, frequency and efficacy of condom usage, and, most pertinently, frequency and efficacy of rectal microbicide usage. To evaluate the potential impact of rectal microbicide usage, we quantify the effect of rectal microbicides (ranging in efficacy from 10% to 90%) on reducing the number of HIV infections in the bathhouse. We conduct uncertainty analyses to assess the effect of variability in both biological and behavioral parameters. We find that even moderately effective rectal microbicides (if used in 10% to 50% of the sex acts) would substantially reduce transmission in bathhouses. For example, a 50% effective rectal microbicide (used in 50% of sex acts) would reduce the number of secondary infections by almost 13% at disease invasion. Our modeling analyses show that even moderately effective rectal microbicides could be very effective prevention tools for reducing transmission in bathhouses and also potentially limit the spread of HIV in the community.

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Mathematics Subject Classification: 92D30.

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