HIV/Aids epidemic in India and predicting the impact of the national response: mathematical modeling and analysis

After two phases of AIDS control activities in India, the third phase of the National AIDS Control Programme (NACP III) was launched in July 2007. Our focus here is to predict the number of people living with HIV/AIDS (PLHA) in India so that the results can assist the NACP III planning team to determine appropriate targets to be activated during the project period (2007-2012). We have constructed a dynamical model that captures the mixing patterns between susceptibles and infectives in both low-risk and high-risk groups in the population. Our aim is to project the HIV estimates by taking into account general interventions for susceptibles and additional interventions, such as targeted interventions among high risk groups, provision of anti-retroviral therapy, and behavior change among HIV-positive individuals. Continuing the current level of interventions in NACP II, the model estimates there will be 5.06 million PLHA by the end of 2011. If 50 percent of the targets in NACP III are achieved by the end of the above period then about 0.8 million new infections will be averted in that year. The current status of the epidemic appears to be less severe compared to the trend observed in the late 1990s. The projections based on the second phase and the third phase of the NACP indicate prevention programmes which are directed towards the general and high-risk populations, and HIV-positive individuals will determine the decline or stabilization of the epidemic. Model based results are derived separately for the revised HIV estimates released in 2007. We perform a Monte Carlo procedure for sensitivity analysis of parameters and model validation. We also predict a positive role of implementation of anti-retroviral therapy treatment of 90 percent of the eligible people in the country. We present methods for obtaining disease progression parameters using convolution approaches. We also extend our models to age-structured populations

The stage-structured epidemic : linking disease and demography with a multi-state matrix approach model

Author Posting. © The Author(s), 2010. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in Theoretical Ecology 4 (2011): 301-319, doi:10.1007/s12080-010-0079-8.Stage-structured epidemic models provide a way to connect the interacting processes of infection and demography. Reproduction and development can replenish the pool of susceptible hosts, and demographic structure leads to heterogeneous transmission and disease risk. Epidemics, in turn, can increase mortality or reduce fertility of the host population. Here we present a framework that integrates both demography and epidemiology in models for stage-structured epidemics. We use the vec-permutation matrix approach to classify individuals jointly by their demographic stage and infection status. We describe demographic and epidemic processes as alternating in time with a periodic matrix models. The application of matrix calculus to this framework allows for the calculation of R0 and sensitivity analysis.P.K. acknowledges support of UNESCO-L’Or´eal Fellowship ”For Women in Science”, Bill and Melinda Gates Foundation, National Institute of Health Grant R01-GM083983-01, National Science Foundation Grant 0742373. H.C. acknowledges support from National Science Foundation Grant DEB-0816514 and the Ocean Life Institute