A complex systems approach to evaluate HIV prevention in metropolitan areas: Preliminary

implications for combination intervention strategies

Brandon DL Marshall, PhDDepartment of Epidemiology

Brown University

Magdalena M Paczkowski & Sandro Galea, Columbia UniversityLars Seemann, University of Houston

Barbara Tempalski, Enrique Pouget, & Samuel R Friedman, NDRI Inc.

Introduction & Conceptual FrameworkThe conceptual framework represents causal effects between two

phenomena – agent characteristics, behaviors & interventions, outputs – in the agent-based model (ABM):

Transmission through an ABM risk network:

HM

HF

WSW

MSM

IDU

NIDU

NDU

Legend:

Estimated HIV Prevalence/Incidence among IDU

Conclusions

• The ABM closely approximated HIV prevalence and incidence among drug users in New York City, 1992-2002.

• Future work will identify optimal combinations of HIV prevention interventions for drug-using populations.

• Although not without challenges, complex systems approaches have the potential to inform “real world” policy scenarios, including combined HIV prevention strategies.

• Additional results will be presented in oral abstract late breaker session C, Friday July 27th at 11:00am in Session Room 6.

This project is funded in part by a 2012 developmental grant from the Lifespan/Tufts/Brown Center for AIDS Research (P30AI042853) and by the National Institutes of Health (R01-

DA013336) as part of the Community Vulnerability and Responses to Drug- User Related HIV/AIDS (CVAR) study. Brandon Marshall was supported by a Postdoctoral Fellowship from the

Canadian Institutes of Health Research. Lars Seemann is supported by the National Science Foundation (Award Number 0840889).