Leng, Trystan and Keeling, Matthew James (2018) Concurrency of partnerships, consistency with data, and control of sexually transmitted infections. Epidemics, 25 . pp. 35-46. doi:10.1016/j.epidem.2018.05.003 ISSN 1755-4365.

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Abstract

Sexually transmitted infections (STIs) are a globally increasing public health problem. Mathematical models, carefully matched to available epidemiological and behavioural data, have an important role to play in predicting the action of control measures. Here, we explore the effect of concurrent sexual partnerships on the control of a generic STI with susceptible-infected-susceptible dynamics. Concurrency refers to being in more than one sexual partnership at the same time, and is difficult to measure accurately. We assess the impact of concurrency through the development of three nested pair-formation models: one where infection can only be transmitted via stable sexual partnerships, one where infection can also be transmitted via casual partnerships between single individuals, and one where those individuals in stable partnerships can also acquire infection from casual partnerships. For each model, we include the action of vaccination before sexual debut to inform about the ability to control. As expected, for a fixed transmission rate, concurrency increases both the endemic prevalence of infection and critical level of vaccination required to eliminate the disease significantly. However, when the transmission rate is scaled to maintain a fixed endemic prevalence across models, concurrency has a far smaller impact upon the critical level of vaccination required. Further, when we also constrain the models to have a fixed number of new partnerships over time (both long-term and casual), then increasing concurrency can slightly decrease the critical level of vaccination. These results highlight that accurate measures and models of concurrency may not always be needed for reliable forecasts when models are closely matched to prevalence data. We find that, while increases in concurrency within a population are likely to generate public-health problems, the inclusion of concurrency may be unnecessary when constructing models to determine the efficacy of the control of STIs by vaccination.

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) Faculty of Science, Engineering and Medicine > Science > Mathematics Faculty of Science, Engineering and Medicine > Research Centres > Warwick Systems Biology Centre
Library of Congress Subject Headings (LCSH):	Sexually transmitted diseases -- Vaccination, Sexually transmitted diseases -- Mathematical models, Vaccines -- Development, Papillomaviruses -- Vaccination
Journal or Publication Title:	Epidemics
Publisher:	Elsevier BV
ISSN:	1755-4365
Official Date:	December 2018
Dates:	Date Event December 2018 Published 14 May 2018 Available 13 May 2018 Accepted
Volume:	25
Page Range:	pp. 35-46
DOI:	10.1016/j.epidem.2018.05.003
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	15 May 2018
Date of first compliant Open Access:	16 May 2018
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID Grant Number 027/0089 National Institute for Health Research http://dx.doi.org/10.13039/501100000272 EP/L015374/1 [EPSRC] Engineering and Physical Sciences Research Council http://dx.doi.org/10.13039/501100000266 EP/L015374/1 Medical Research Council http://dx.doi.org/10.13039/501100000265

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