Estimated population mixing by country and risk cohort for the HIV/AIDS epidemic in Western Europe

Abstract.

 This paper applies a compartmental epidemic model to estimating the mixing relations that support the transfer of HIV infection between risk populations within the countries of Western Europe. To this end, a space-time epidemic model with compartments representing countries with populations specified to be at high (gay men and intravenous drug injectors ever with AIDS) and low (the remainder who are sexually active) risk is described. This model also allows for contacts between susceptible and infectious individuals by both local and international travel. This system is calibrated to recorded AIDS incidence and the best-fit solution provides estimates of variations in the rates of mixing between the compartments together with a reconstruction of the transmission pathway. This solution indicates that, for all the countries, AIDS incidence among those at low risk is expected to remain extremely small relative to their total number. A sensitivity analysis of the low risk partner acquisition rate, however, suggests this endemic state might be fragile within Europe during this century. The discussion examines the relevance of these mixing relationships for the maintenance of disease control.