在阿姆斯特丹男男性行为者中，风险行为的增加可能超过抗逆转录病毒药物治疗对HIV发病率的益处
Increasing risk behavior can outweigh the benefits of anti-retroviral drug treatment on the HIV incidence among men-having-sex-with-men in Amsterdam
摘要：
在工业化国家，通过男男性行为者（男男性行为者）之间的接触传播是艾滋病毒流行的主要原因之一。在荷兰首都阿姆斯特丹，MSM风险群体已经被追踪了几十年。这促使了一些研究，从统计学、心理学和社会学的角度提供了关于男男性接触者危险行为的详细信息。尽管有效的抗逆转录病毒疗法的时代，艾滋病毒的发病率在男男性行为者增加。从长远来看，危险行为和有效治疗的矛盾效应仍然知之甚少。使用先前提出的复杂代理网络模型，我们描述了稳定和休闲的伙伴关系，以预测艾滋病毒在男男性接触者之间的传播。行为相关的参数和值，从阿姆斯特丹MSM的研究推断，被送入模型，我们使用历史的年度发病率数据验证模型。随后，我们研究的方案，以评估风险行为和有效治疗的矛盾影响，通过改变相应的参数值。最后，我们进行定量分析的基础上产生的发病率数据。模拟的发病率再现ACS的历史发病率以及有助于预测艾滋病毒在阿姆斯特丹的男男性接触者之间的流行。我们的研究结果表明，从长远来看，有效治疗的积极影响可以被MSM风险行为至少30%的增加所抵消。结论：我们建议，根据模型预测，降低风险的行为是显着的控制机制，艾滋病毒的发病率，即使在有效的治疗。
英文摘要：
The transmission through contacts among MSM (men who have sex with men) is one of the dominating contributors to HIV prevalence in industrialized countries. In Amsterdam, the capital of the Netherlands, the MSM risk group has been traced for decades. This has motivated studies which provide detailed information about MSM's risk behavior statistically, psychologically and sociologically. Despite the era of potent antiretroviral therapy, the incidence of HIV among MSM increases. In the long term the contradictory effects of risk behavior and effective therapy are still poorly understood. Using a previously presented Complex Agent Network model, we describe steady and casual partnerships to predict the HIV spreading among MSM. Behavior-related parameters and values, inferred from studies on Amsterdam MSM, are fed into the model; we validate the model using historical yearly incidence data. Subsequently, we study scenarios to assess the contradictory effects of risk behavior and effective therapy, by varying corresponding values of parameters. Finally, we conduct quantitative analysis based on the resulting incidence data. The simulated incidence reproduces the ACS historical incidence well and helps to predict the HIV epidemic among MSM in Amsterdam. Our results show that in the long run the positive influence of effective therapy can be outweighed by an increase in risk behavior of at least 30% for MSM. Conclusion: We recommend, based on the model predictions, that lowering risk behavior is the prominent control mechanism of HIV incidence even in the presence of effective therapy.
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