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Perceived risk induced multiscale model: Coupled within-host and between-host dynamics and behavioral dynamics.

Xiaodan Sun1, Weike Zhou2, Yuhua Ruan3

  • 1School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, 710049, PR China.

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|December 12, 2024
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Summary

A new model shows that improving HIV/AIDS treatment alone may not eliminate infections. Behavioral changes and population-level interventions are crucial for ending the AIDS epidemic.

Keywords:
Behavioral dynamicsHIV/AIDSMultiscale modelRisk perception

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Area of Science:

  • Epidemiology
  • Mathematical Biology
  • Virology

Background:

  • Understanding the complex interplay between individual behavior, disease spread, and viral progression is crucial for effective HIV/AIDS control.
  • Existing models often struggle to capture the bidirectional coupling between within-host viral dynamics and between-host transmission dynamics.

Purpose of the Study:

  • To develop and validate a novel multiscale model that integrates behavioral, disease transmission, and viral dynamics.
  • To investigate the co-evolutionary mechanisms linking within-host and between-host processes in HIV/AIDS.
  • To identify potential reasons for the difficulty in eliminating HIV/AIDS solely through treatment strategies.

Main Methods:

  • Formulation of a novel multiscale mathematical model incorporating perceived risk as a bridge between behavioral and disease dynamics.
  • Validation of the model using real-world data to ensure its predictive accuracy.
  • Analysis of the model's dynamic behaviors, including oscillations and discordance between transmission and viral dynamics.

Main Results:

  • The model demonstrates that increased treatment efficacy can paradoxically lead to more infections, highlighting limitations of treatment-only strategies for HIV/AIDS.
  • A "nearly elimination" phenomenon was observed under specific conditions (low behavioral risk threshold, increased treatment efficacy, unchanged diagnosis rates), characterized by a temporary drop followed by a resurgence in new infections.
  • Sustained awareness and consistent high-risk behaviors were identified as factors contributing to infection resurgence.

Conclusions:

  • Intervention strategies for HIV/AIDS must address both individual-level behavioral changes and population-level dynamics.
  • Relying solely on improved treatment efficacy without enhancing diagnosis rates and behavioral interventions may be insufficient for HIV/AIDS elimination.
  • A comprehensive approach, integrating biomedical and behavioral strategies, is essential to achieve the goal of "ending the AIDS" epidemic.