Document 0128
 DOCN  M95A0128
 TI    Modelling AIDS reduction strategies.
 DT    9510
 AU    Kault DA; Anton Breinl Centre for Tropical Health and Medicine, James
       Cook; University, Townsville, Queensland, Australia.
 SO    Int J Epidemiol. 1995 Feb;24(1):188-97. Unique Identifier : AIDSLINE
       MED/95317897
 AB    BACKGROUND. Mathematical models of the AIDS epidemic have not been able
       to give accurate predictions about the size of the epidemic because it
       is not possible to obtain sufficiently accurate measurements of the
       factors that enable HIV transmission. The uncertainties inherent in
       models of the AIDS epidemic appear to limit their relevance to
       epidemiologists. However, it is shown here that the uncertainties need
       not prevent models being used to make reliable decisions about which
       preventive strategy will be most effective. METHOD. A range of
       strategies are simulated in a model of the AIDS epidemic. The
       simulations are repeated as the value of what seems to be the most
       important uncertain factor, is varied. The effect of this variation on
       the effectiveness of each strategy is noted. In principle, the process
       could be repeated whilst all other uncertain factors are varied as well.
       RESULTS. Although varying one uncertain factor created enormous
       variation in the size of the epidemic, it is remarkable that for most
       preventive strategies the relative effectiveness of the strategies was
       barely altered. Hence for the most part the ranking of strategies in
       order of effectiveness is not affected by the area of uncertainty
       explored here. The results also highlight the potential effectiveness
       not only of general condom promotion, but also the use of circumcision
       and spermicides and general screening or targetted screening in sexually
       transmitted disease clinics. CONCLUSIONS. Epidemiological modelling may
       accurately rank the effectiveness of interventions although it may fail
       to predict the size of the epidemic.
 DE    Acquired Immunodeficiency Syndrome/*EPIDEMIOLOGY/*PREVENTION &
       CONTROL/TRANSMISSION  Adult  Circumcision  Condoms  Female
       Gonorrhea/PREVENTION & CONTROL/TRANSMISSION  Human  HIV
       Seropositivity/EPIDEMIOLOGY  Male  *Models, Theoretical  Spermatocidal
       Agents  Support, Non-U.S. Gov't  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).