Different Patterns of HIV Expansion Between High-income and Non-rich Countries and the Potential Drivers during the 1980s
Keywords:Poverty, HIV, global patterns, dynamics, HIV subtypes, urbanization, malaria
Disease dynamics theory predicts that after the introduction of an infected individual into a susceptible population, the number of infected individuals will grow exponentially until a point at which the depletion of the susceptible class starts to affect the rate of increase of the infectious class. The disease then starts to self-limit its own rate of increase towards an equilibrium with the size of the infectious population. Here, we explored whether the HIV dynamics described exponential growth as theoretically predicted during the 1980s decade for 64 countries. We focused on the HIV population rate of change per infectious individual ( RHIV ) of the infectious class. We used nonlinear regression between HIV infectious class size and RHIV to determine the dynamic behavior of HIV. The prevalence of HIV increased exponentially in most countries, except for high-income countries. The world during the 1980s could be separated into two groups based on HIV dynamics at the country scale.
We performed a multivariate analysis with variables mentioned in the HIV literature to explore the preexisting scenarios that could influence this global separation with regard to HIV dynamics. Poverty levels, malaria burden, the prevalence of men who have sex with men, the prevalence of sex workers, the modes of transmission (HIV subtypes) and the urbanization process could interact to explain the differences among countries with regard to HIV dynamics. The results suggest that during the 1980s, we could divide the world into two groups based on the HIV exponential (non-rich countries) and logistic growth patterns (high-income countries).
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