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Heterosexual Behavior Patterns and the Spread of HIV/AIDS: The Interacting Effects of Rate of Partner Change and Sexual Mixing

Hertog, Sara MS

doi: 10.1097/OLQ.0b013e31805ba84c

Objectives: This study evaluates whether the influence of sexual mixing patterns on the human immunodeficiency virus (HIV) epidemic curve is sensitive to the prevailing rates of sexual partner change in a population.

Study Design: A biobehavioral macrosimulation model is employed to assess the interacting dynamics of the rates of sexual partner change and patterns of sexual mixing between population subgroups. HIV spread is simulated under 2 rates of partner change scenarios and under various degrees of assortativeness in sexual mixing patterns.

Results: With high rates of partner change, disassortativeness in sexual mixing tends to increase the overall size of the HIV epidemic. However, when relatively low rates of partner change are simulated, disassortative mixing yields a smaller epidemic. This pattern is further influenced by the underlying sexual transmission probabilities of HIV.

Conclusions: Each of the various determinants of the sexual spread of HIV must not be considered in isolation. Instead, the interactive nature of those determinants should be accounted for in discussions of HIV epidemic dynamics.

Simulations of HIV spread reveal that sexual mixing patterns' effect on the size and shape of the epidemic curve varies according to rates of partner change in a population.

From the Center for Demography and Ecology, University of Wisconsin–Madison, Madison, Wisconsin

The author thanks M. Giovanna Merli, James Holland Jones, Karen Swallen, and 3 anonymous reviewers for their invaluable comments on earlier drafts of this manuscript and Alberto Palloni for his assistance in adapting the macrosimulation model.

Supported by resources provided by the Center for Demography and Ecology, University of Wisconsin, Madison, and by an NICHD training grant.

An earlier version of this article was presented at the Population Association of America meetings held in Los Angeles, CA, March 30 to April 1, 2006.

Correspondence: Sara Hertog, MS, Center for Demography and Ecology, University of Wisconsin–Madison, 1180 Observatory Drive, Madison, WI 53706. E-mail:

Received for publication December 15, 2006, and accepted March 9, 2007.

© Copyright 2007 American Sexually Transmitted Diseases Association