The spread of HIV through a population is influenced by many factors. These include the frequency and type of sexual activity, age distribution of the population, use of intravenous drugs and behaviors associated with their use, the pattern of infectivity of the virus during the several stages of the infection, geographic location, and the patterns of interaction among individuals and the context in which those interactions occur.A number of questions about the natural history and epidemiology of AIDS remain unanswered. Since the disease has only recently been recognized, historical data are unavailable to aid in answering these questions. Mathematical models provide one approach that can be of use in understanding the spread of the disease.Because of the complexity of the biology and epidemiology of AIDS, useful models must focus on specific aspects of the disease. In addition to a brief review of existing models for the spread of AIDS, a new model which incorporates the effects of social context operating at the time of a sexual.encounter is described. The model considers the spread of the disease in a population of homosexual men divided into groups based on relative risk for the disease. Individuals are assigned to a specific group on the basis of their normal sexual activities, but they may take on the characteristics of a different risk group temporarily given the conditions operating when they engage in a sexual encounter. Results from preliminary analyses of the new model indicate that the major effects of incorporating social context include a decrease in the number of cases of the disease, sometimes by an order of magnitude or more, delayed spread of the disease, and a decreased impact of the disease on low and medium risk groups.
2The AIDS epidemic is one of the major public health emergencies of this century. This has stimulated highly productive research efforts in a number of fields, including epidemiology, immunology, clinical medicine, sociology, and applied mathematics. This paper will review the contributions made by applied mathematicians and mathematical or theoretical epidemiologists to understanding the spread of AIDS in modem populations. In addition, a new model which incorporates factors operating at the time of contact between individuals will be described.A number of mathematical models have been developed to describe the transmission system of IDV, the virus responsible for AIDS. These models help to provide a framework with which to explore the nature of disease spread through a population, the effects of behavior change on the rates of spread, the effectiveness of control strategies, the consequences of different patterns of contact among individuals in a population, and other similar questions. Analysis of such models provides valuable knowledge and understanding of biological and social factors influencing disease transmission -understanding that may not be available from statistical analyses.
NATURAL IDSTORY AND EPIDEMIOLOOY OF AIDSAIDS is a clinical syndrome associated with seve...