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Open Access Highly Accessed Research article

Increasing risk behaviour can outweigh the benefits of antiretroviral drug treatment on the HIV incidence among men-having-sex-with-men in Amsterdam

Shan Mei12*, Rick Quax2, David van de Vijver3, Yifan Zhu1 and P M A Sloot245

Author Affiliations

1 Information System and Management College, National University of Defense Technology, Changsha, China

2 Computational Science, University of Amsterdam, Amsterdam, Netherlands

3 Dept. of Virology, Erasmus MC, University Medical Centre Rotterdam, Netherlands

4 National Research University ITMO, Russia

5 Nanyang Technological University, Singapore

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BMC Infectious Diseases 2011, 11:118  doi:10.1186/1471-2334-11-118

Published: 11 May 2011

Abstract

Background

The transmission through contacts among MSM (men who have sex with men) is one of the dominating contributors to HIV prevalence in industrialized countries. In Amsterdam, the capital of the Netherlands, the MSM risk group has been traced for decades. This has motivated studies which provide detailed information about MSM's risk behavior statistically, psychologically and sociologically. Despite the era of potent antiretroviral therapy, the incidence of HIV among MSM increases. In the long term the contradictory effects of risk behavior and effective therapy are still poorly understood.

Methods

Using a previously presented Complex Agent Network model, we describe steady and casual partnerships to predict the HIV spreading among MSM. Behavior-related parameters and values, inferred from studies on Amsterdam MSM, are fed into the model; we validate the model using historical yearly incidence data. Subsequently, we study scenarios to assess the contradictory effects of risk behavior and effective therapy, by varying corresponding values of parameters. Finally, we conduct quantitative analysis based on the resulting incidence data.

Results

The simulated incidence reproduces the ACS historical incidence well and helps to predict the HIV epidemic among MSM in Amsterdam. Our results show that in the long run the positive influence of effective therapy can be outweighed by an increase in risk behavior of at least 30% for MSM.

Conclusion

We recommend, based on the model predictions, that lowering risk behavior is the prominent control mechanism of HIV incidence even in the presence of effective therapy.