Figure 1.
Heterogeneity in HIV transmission potential…
Figure 1.
Heterogeneity in HIV transmission potential among individuals in the EMOD-HIV model. ( a…
Figure 1.Heterogeneity in HIV transmission potential among individuals in the EMOD-HIV model. (a) The distribution of the number of times an infected individual transmits HIV. Faded x's show individual simulation results, whereas o's show the mean of 20 simulation results. The colours used to plot the number of non-transmitters, single-transmitters, etc. are used for the same transmitter groups in subsequent panels. Next, transmitting couples are categorized based on static properties: the transmitter's concurrency ‘flags’ (marital, informal or transitory), STI status of the transmitter or recipient, sex of the transmitter and circumcision status of a male transmitter or recipient. In (b), the proportions of transmitters and recipients who transmit zero, one, etc. times are shown as stacked bar charts, whereas the proportions of zero, one, etc. transmitters who have the indicated property are shown as individual simulations (x's) and means (o's). Similarly, the stacked area chart in (c) shows the proportion of each age group of transmitters and recipients who transmit zero, one, etc. times, whereas the curves show the age distributions for zero-, one-, etc. transmitters, with faded lines representing single simulations and dark lines showing the mean. These are shown as a function of the transmitter's age, recipient's age and transmitter's age at the time that the transmitter was originally infected.
Figure 2.
Comparison of age-mixing patterns used…
Figure 2.
Comparison of age-mixing patterns used for model input, realized as model output, and…
Figure 2.Comparison of age-mixing patterns used for model input, realized as model output, and occurring during transmission of HIV. A MOPAD (a) is used as input for the PFA forming each partnership type. On average, transitory relationships recruit the youngest individuals, create the smallest age gap between partners and have the shortest durations, whereas marital partnerships recruit the oldest individuals, create the largest age gap between partners (approx. 5 years) and have the longest durations. The age-mixing pattern upon formation of these partnerships (b) is close to the MOPADs, but with added noise reflecting the stochastic nature of the simulation. The age pattern of couples at the time of HIV transmission (c) is older, as HIV is transmitted after partnerships have formed. This age lag can also be seen after averaging across the three types (d).
Figure 3.
Sample lifecourses and chains of…
Figure 3.
Sample lifecourses and chains of transmission. ( a,c ) A lifetime of relationships…
Figure 3.Sample lifecourses and chains of transmission. (a,c) A lifetime of relationships and HIV transmission from the perspective of a male and female individual, respectively. (i) The relationship gaps between the individual (darker line at zero) and their transitory (red), informal (green) and marital (blue) partners. Horizontal lines become thick when individuals become infected. Vertical lines indicate transmission events during the acute (dotted lines), latent (solid lines) or acquired immunodeficiency syndrome (AIDS) (dashed-dotted lines) stage. Note that the partners can become infected from outside the relationship shown. (ii) The number of simultaneous partnerships against the individual's age. (b,d) The tree of downstream transmissions that originate in the root individual in (a) and (c), respectively. Transmission events are plotted at the time of transmission and age of the receiving individual. Connecting lines show the type of relationship causing the upcoming transmission (red, transitory; green, informal; blue, marital) and the stage of disease during transmission (dotted, acute; solid, latent; dashed-dotted, AIDS).
Figure 4.
Proportion of transmissions that are…
Figure 4.
Proportion of transmissions that are non-ageing. ( a ) Scatter plot of all…
Figure 4.Proportion of transmissions that are non-ageing. (a) Scatter plot of all transmission events in a simulation, showing the years since the transmitting individual was infected (horizontal axis) and age gap between the partners (vertical axis). Transmissions that fall within the black triangle are non-ageing, i.e. when the recipient is younger than the transmitter at their respective infection times. Overlaid blue points are male-to-female transmissions only; green points are transmissions from 30-year-old males; red points are transmissions from 20-year-old males. (b) Proportion of male-to-female (blue), female-to-male (red) and all (black) transmissions that are non-ageing, by age of the transmitter. Faded lines show individual simulations. Dark lines show the mean of 20 simulations. Dashed lines show 1 s.d. from the mean, which diverges from the mean as the number of transmissions increases to numbers that are more rare.
Figure 5.
Number of round trips, NARTs…
Figure 5.
Number of round trips, NARTs and NARTs per infectious person-year, as a function…
Figure 5.Number of round trips, NARTs and NARTs per infectious person-year, as a function of age. The diagram illustrates a possible non-ageing male–female–male round trip, with time represented on the horizontal axis and age on the vertical axis. (a) The total number of round-trip transmissions in a simulation, as a function of the age of the first individual in the round-trip chain at his/her time of infection (grey-shaded area). These are disaggregated into male–female–male round trips (blue area) and female–male–female round trips (red area). Below the shading, lines show the subset of these round trips that are non-ageing: male-to-female (blue), female-to-male (red) and all (black). (b) Number of NARTs (of the specified age and sex, as in (a)) per infected sexually active person-year at the sex and age of the first individual's time of infection. (c) Number of total round trips and NARTs, as in (a), as a function first individual's age at the time of transmission. (d) NARTs per infectious person-year, as in (c), as a function of the first individual's age at the time of transmission. Person-years are also calculated for the age at transmission. In (a–d), faded lines show individual simulations and dark lines show the mean of 20 simulations.
Figure 6.
NARTs by decade. The number…
Figure 6.
NARTs by decade. The number of male-to-female (blue), female-to-male (red) and all (black)…
Figure 6.NARTs by decade. The number of male-to-female (blue), female-to-male (red) and all (black) NARTs per infectious person-year (PY) (of the corresponding age and sex) are plotted as a function of the first individual's age. In (a), age (horizontal axes) and person-years (denominator for vertical axes) are calculated at the age of the first individual during his/her initial infection. In (b), these are calculated at the age of the first individual during transmission. The non-ageing transmission chains are subdivided by decade according to the date of the first transmission. Faded lines show individual simulations and dark lines show the mean of 20 simulations. Although more transmissions per person-year occur in the earlier epidemic, the age pattern remains constant over time.
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