Double trouble: modelling the impact of low risk perception and high-risk sexual behaviour on chlamydia transmission

Abstract

Risk perception plays an important role in testing behaviour for sexually transmitted infections, but is rarely included in mathematical models exploring the impact of testing. We explored the impact of incorporating sexual behaviour (SB), risk perception (RP) and differential testing uptake in SB-RP groups on prevalence, using chlamydia as an example. We developed a pair model with a susceptible-infected-susceptible structure representing heterosexuals aged 16-26 years. The effect of testing on chlamydia prevalence was compared between a model with only SB (SB model) and a model with SB and RP (SB-RP model). In the SB-RP model, a scenario without differential testing uptake in SB-RP groups was compared to scenarios with differential testing uptake in SB-RP groups. Introducing testing into the SB-RP model resulted in a slightly smaller reduction in chlamydia prevalence (-38.0%) as compared to the SB model (-40.4%). In the SB-RP model, the scenario without differential testing uptake in SB-RP groups overestimated the reduction in chlamydia prevalence (with 4.8%), especially in the group with high SB and low RP (19.8%). We conclude that mathematical models incorporating RP and differential testing uptake in SB-RP groups improve the impact assessment of testing and treatment on chlamydia prevalence.

Introducing pre-exposure prophylaxis to prevent HIV acquisition among men who have sex with men in Sweden: insights from a mathematical pair formation model

“…Finally, our model does not incorporate concurrent steady partnerships. This is a common assumption for compartmental models,8 15 26 and inclusion would possibly strengthen the model. However, our model does consider casual sex partners concurrent to steady partners.…”

Who drops out and when? Predictors of non-response and loss to follow-up in a longitudinal cohort study among STI clinic visitors

“…A possible explanation for this contradictory finding is that we examined the association between risk perception at baseline and loss to follow-up one year later, and not risk perception after one year. It might be that risk perception decreased after baseline in Amsterdam, because individuals believed they were engaging in less risky sexual behavior than before or they believed they overestimated their risk at baseline [43]. Lower risk perception at the follow-up moments might have negatively influenced the motivation to participate in the follow-up moments.…”

Simultaneous Detection of Neisseria gonorrhoeae and Fluoroquinolone Resistance Mutations to Enable Rapid Prescription of Oral Antibiotics

“…While this indicates that those at highest risk do find the SHC, it also indicates that high-risk behaviour is ongoing. Low risk perception in combination with high-risk behaviour plays an important role in the acquisition of STI 18 . Sexual risk behaviours combined with psychological factors are defining factors in STI risk and tailoring preventive messages to these factors during STI consultations is encouraged 18,19 .…”

“…Low risk perception in combination with high-risk behaviour plays an important role in the acquisition of STI 18 . Sexual risk behaviours combined with psychological factors are defining factors in STI risk and tailoring preventive messages to these factors during STI consultations is encouraged 18,19 . Further efforts, such as promotion of condom use, repeated testing and more effective (timely and complete) partner notification are needed to ensure that people in high-risk groups effectively improve their sexual health and that of their partners.…”