Modelling dynamic interactions between risk perception, partner choice, HIV transmission, and HIV interventions
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Abstract
Since the early 1980's HIV has become a pandemic. Medical research aimed at increasing the lifespan and reducing the burden of those infected has improved dramatically allowing infected individuals the chance at a near normal life expectancy. In addition, researchers hoping to create a prophylactic HIV vaccine appear to be close to reaching their goal. These recent medical advancements have prompted many researchers to study how this may alter HIV spread. Reasons for this are motivated by the fact that despite awareness campaigns, incidence rates in high-risk groups, such as MSM, have increased. This has led to worry that highly active anti-retroviral treatment (HAART) optimism may worsen the situation. Many researchers have incorporated elements of varying behaviour into compartment HIV transmission models to predict such effects, but the results have been varied. This thesis explores the behaviour aspect involved in the decision-making and partner selection process using an approach that differs from past papers. Using an agent based model we explore the dynamics of risk perception shaping individual behaviour, and the impact this has on HIV spread. We demonstrate that distinct groups, as defined by their sexual behaviour, HIV status, and risk perceptions, can emerge. We incorporate age structure to explore behavioural responses to interventions, such as HAART and prophylactic vaccine. We find that interventions can activate several feedback mechanisms that influence decision-making and HIV prevalence. We then explore the noncooperative player interaction by investigating multiplayer nonlinear games solved with variational analysis techniques. We demonstrate the sensitivity of Nash strategies of players with respect to variation of their preferences and beliefs. Our findings use a novel approach to help describe how HIV spread and interventions influence a number of aspects, such as transmission, demography, sexual behaviour and risk perception.