Joint modeling HIV and HPV using a new hybrid agent-based network and compartmental simulation technique.

Persons living with human immunodeficiency virus (HIV) have a disproportionately higher burden of human papillomavirus infection (HPV)-related cancers. Causal factors include both behavioral and biological. While pharmaceutical and care support interventions help address biological risk of coinfecti...

Full description

Bibliographic Details
Main Authors: Xinmeng Zhao, Chaitra Gopalappa
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0288141&type=printable
_version_ 1797633270053076992
author Xinmeng Zhao
Chaitra Gopalappa
author_facet Xinmeng Zhao
Chaitra Gopalappa
author_sort Xinmeng Zhao
collection DOAJ
description Persons living with human immunodeficiency virus (HIV) have a disproportionately higher burden of human papillomavirus infection (HPV)-related cancers. Causal factors include both behavioral and biological. While pharmaceutical and care support interventions help address biological risk of coinfection, as social conditions are common drivers of behaviors, structural interventions are key part of behavioral interventions. Our objective is to develop a joint HIV-HPV model to evaluate the contribution of each factor, to subsequently inform intervention analyses. While compartmental modeling is sufficient for faster spreading HPV, network modeling is suitable for slower spreading HIV. However, using network modeling for jointly modeling HIV and HPV can generate computational complexities given their vastly varying disease epidemiology and disease burden across sub-population groups. We applied a recently developed mixed agent-based compartmental (MAC) simulation technique, which simulates persons with at least one slower spreading disease and their immediate contacts as agents in a network, and all other persons including those with faster spreading diseases in a compartmental model, with an evolving contact network algorithm maintaining the dynamics between the two models. We simulated HIV and HPV in the U.S. among heterosexual female, heterosexual male, and men who have sex with men (men only and men and women) (MSM), sub-populations that mix but have varying HIV burden, and cervical cancer among women. We conducted numerical analyses to evaluate the contribution of behavioral and biological factors to risk of cervical cancer among women with HIV. The model outputs for HIV, HPV, and cervical cancer compared well with surveillance estimates. Model estimates for relative prevalence of HPV (1.67 times) and relative incidence of cervical cancer (3.6 times), among women with HIV compared to women without, were also similar to that reported in observational studies in the literature. The fraction attributed to biological factors ranged from 22-38% for increased HPV prevalence and 80% for increased cervical cancer incidence, the remaining attributed to behavioral. The attribution of both behavioral and biological factors to increased HPV prevalence and cervical cancer incidence suggest the need for behavioral, structural, and pharmaceutical interventions. Validity of model results related to both individual and joint disease metrics serves as proof-of-concept of the MAC simulation technique. Understanding the contribution of behavioral and biological factors of risk helps inform interventions. Future work can expand the model to simulate sexual and care behaviors as functions of social conditions to jointly evaluate behavioral, structural, and pharmaceutical interventions for HIV and cervical cancer prevention.
first_indexed 2024-03-11T11:51:43Z
format Article
id doaj.art-3bb1dddb322a483fb84bd71e6e4db113
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-03-11T11:51:43Z
publishDate 2023-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-3bb1dddb322a483fb84bd71e6e4db1132023-11-09T05:32:11ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011811e028814110.1371/journal.pone.0288141Joint modeling HIV and HPV using a new hybrid agent-based network and compartmental simulation technique.Xinmeng ZhaoChaitra GopalappaPersons living with human immunodeficiency virus (HIV) have a disproportionately higher burden of human papillomavirus infection (HPV)-related cancers. Causal factors include both behavioral and biological. While pharmaceutical and care support interventions help address biological risk of coinfection, as social conditions are common drivers of behaviors, structural interventions are key part of behavioral interventions. Our objective is to develop a joint HIV-HPV model to evaluate the contribution of each factor, to subsequently inform intervention analyses. While compartmental modeling is sufficient for faster spreading HPV, network modeling is suitable for slower spreading HIV. However, using network modeling for jointly modeling HIV and HPV can generate computational complexities given their vastly varying disease epidemiology and disease burden across sub-population groups. We applied a recently developed mixed agent-based compartmental (MAC) simulation technique, which simulates persons with at least one slower spreading disease and their immediate contacts as agents in a network, and all other persons including those with faster spreading diseases in a compartmental model, with an evolving contact network algorithm maintaining the dynamics between the two models. We simulated HIV and HPV in the U.S. among heterosexual female, heterosexual male, and men who have sex with men (men only and men and women) (MSM), sub-populations that mix but have varying HIV burden, and cervical cancer among women. We conducted numerical analyses to evaluate the contribution of behavioral and biological factors to risk of cervical cancer among women with HIV. The model outputs for HIV, HPV, and cervical cancer compared well with surveillance estimates. Model estimates for relative prevalence of HPV (1.67 times) and relative incidence of cervical cancer (3.6 times), among women with HIV compared to women without, were also similar to that reported in observational studies in the literature. The fraction attributed to biological factors ranged from 22-38% for increased HPV prevalence and 80% for increased cervical cancer incidence, the remaining attributed to behavioral. The attribution of both behavioral and biological factors to increased HPV prevalence and cervical cancer incidence suggest the need for behavioral, structural, and pharmaceutical interventions. Validity of model results related to both individual and joint disease metrics serves as proof-of-concept of the MAC simulation technique. Understanding the contribution of behavioral and biological factors of risk helps inform interventions. Future work can expand the model to simulate sexual and care behaviors as functions of social conditions to jointly evaluate behavioral, structural, and pharmaceutical interventions for HIV and cervical cancer prevention.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0288141&type=printable
spellingShingle Xinmeng Zhao
Chaitra Gopalappa
Joint modeling HIV and HPV using a new hybrid agent-based network and compartmental simulation technique.
PLoS ONE
title Joint modeling HIV and HPV using a new hybrid agent-based network and compartmental simulation technique.
title_full Joint modeling HIV and HPV using a new hybrid agent-based network and compartmental simulation technique.
title_fullStr Joint modeling HIV and HPV using a new hybrid agent-based network and compartmental simulation technique.
title_full_unstemmed Joint modeling HIV and HPV using a new hybrid agent-based network and compartmental simulation technique.
title_short Joint modeling HIV and HPV using a new hybrid agent-based network and compartmental simulation technique.
title_sort joint modeling hiv and hpv using a new hybrid agent based network and compartmental simulation technique
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0288141&type=printable
work_keys_str_mv AT xinmengzhao jointmodelinghivandhpvusinganewhybridagentbasednetworkandcompartmentalsimulationtechnique
AT chaitragopalappa jointmodelinghivandhpvusinganewhybridagentbasednetworkandcompartmentalsimulationtechnique