Transmission Models and the Understanding of HIV Transmission Dynamics

2/21/99


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Table of Contents

Transmission Models and the Understanding of HIV Transmission Dynamics

Familiarity With Transmission Models Detects Inconsistencies in Knowledge

Transmission Models Generate Epidemic Curves With Certain Shapes

How People Were Thinking About the HIV Transmission System

Epidemic Curves Consistent With Assumptions About Transmission

Expected Curves When Contact Rate Cut to 1/3 Previous

The Shape of the Epidemic Curve After the Initial Rise Gives Hints About Social and Biological Determinants

Examining Epidemic Curves to Evaluate R0 and its Determinants

Varying Transmission Probabilities by Stage of Infection are Needed to Explain Epidemic Curves

Realistic Complexities of Behavior Change and Contact Patterns Amplify the Effects of Varying Transmission Probablities

Factors that augment the importance of early infection in transmission

Stages of HIV Infection

Greater level of virus in the first stages of infection

Greater level of virus in the first stages of infection

How do we come to understand the pattern of viremia and its determinants?

Fundamental issues still unresolved about virus dynamics at set point

Current controversies about the pattern of virus levels at different stages

Effect of transmission a short time after infection

Periods of high risk behavior in high risk populations

How do we know that early infection is important in dynamics?

Transmission probabilities by stage of infection

Why is it so important to understand the role of early infection

The effect of treatment on population levels of transmission

Control Program Efforts We Pursue on the Basis of Model Derived Insights

Surveillance using partner data

Vaccine Effect Model in Individuals

Effects on transmission of vaccine reduction of virus reproduction rates

Possible effect of vaccine induced immunity on viral dynamics

Possible effect of vaccine induced immunity on virus dynamics

Effects on transmission of reducing chance that transmitted virus replicates

Implications for vaccination programs of potential VEI without VES

Vaccine Effect Model in Individuals

Relationships between Vaccine Effects

Synthesis

Author: James Koopman

Email: jkoopman@umich.edu

Home Page: http://www.sph.umich.edu/group/epid/epid655/epi655.htm