Using data from 'visible' populations to estimate the size and importance of 'hidden' populations in an epidemic: A modelling technique.
ART, antiretroviral therapy
FSW, female sex worker
HIV
IBBA, integrated biological and behavioural assessment survey
India
Infectious diseases
MSM/TGW, cisgender men or transgender women, who have sex with cisgender men or transgender women
Mathematical modelling
Men who have sex with men
PB, panthis and bisexuals
SBS, special behavioural survey
Transgender women
Journal
Infectious Disease Modelling
ISSN: 2468-0427
Titre abrégé: Infect Dis Model
Pays: China
ID NLM: 101692406
Informations de publication
Date de publication:
2020
2020
Historique:
received:
07
02
2020
accepted:
24
09
2020
entrez:
26
10
2020
pubmed:
27
10
2020
medline:
27
10
2020
Statut:
epublish
Résumé
We used reported behavioural data from cisgender men who have sex with men and transgender women (MSM/TGW) in Bangalore, mainly collected from 'hot-spot' locations that attract MSM/TGW, to illustrate a technique to deal with potential issues with the representativeness of this sample. A deterministic dynamic model of HIV transmission was developed, incorporating three subgroups of MSM/TGW, grouped according to their reported predominant sexual role (insertive, receptive or versatile). Using mathematical modelling and data triangulation for 'balancing' numbers of partners and role preferences, we compared three different approaches to determine if our technique could be useful for inferring characteristics of a more 'hidden' insertive MSM subpopulation, and explored their potential importance for the HIV epidemic. Projections for 2009 across all three approaches suggest that HIV prevalence among insertive MSM was likely to be less than half that recorded in the surveys (4.5-6.5% versus 13.1%), but that the relative size of this subgroup was over four times larger (61-69% of all MSM/TGW versus 15%). We infer that the insertive MSM accounted for 10-20% of all prevalent HIV infections among urban males aged 15-49. Mathematical modelling can be used with data on 'visible' MSM/TGW to provide insights into the characteristics of 'hidden' MSM. A greater understanding of the sexual behaviour of all MSM/TGW is important for effective HIV programming. More broadly, a hidden subgroup with a lower infectious disease prevalence than more visible subgroups, has the potential to contain more infections, if the hidden subgroup is considerably larger in size.
Identifiants
pubmed: 33102985
doi: 10.1016/j.idm.2020.09.007
pii: S2468-0427(20)30052-X
pmc: PMC7566088
doi:
Types de publication
Journal Article
Langues
eng
Pagination
798-813Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/R015600/1
Pays : United Kingdom
Informations de copyright
© 2020 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no conflict of interests.
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