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2010, 7(4): 871-904. doi: 10.3934/mbe.2010.7.871

A two-sex model for the influence of heavy alcohol consumption on the spread of HIV/AIDS

1. 

Department of Mathematics, University of Botswana, Private Bag 0022, Gaborone, Botswana, Botswana

Received  October 2009 Revised  May 2010 Published  October 2010

The HIV/AIDS epidemic, one of the leading public health problems to have affected sub-Sahara Africa, is a multifaceted problem with social, behavioral and biological aspects. In the absence of a cure, behavioral change has been advocated as an intervention strategy for reversing the epidemic. Empirical studies have found heavy alcohol consumption to be a fueling factor for HIV/AIDS infection and progression. Previously [20], we formulated and analyzed a one-sex deterministic model to capture the dynamics of this deadly interaction. But, since alcohol drinking habits, consequent risky sexual practices, alcohol-induced immune suppression, etc., can be different for men and women, the primary objective of our present paper is to construct a two-sex model aimed at shedding light on how both sexes, with varying heavy alcohol consumption trends, contribute differently to the HIV/AIDS spread. Based on numerical simulations, supported by the UNAIDS epidemiological software SPECTRUM and using the available data, our study identifies heavy drinking among men and women to be a major driving force for HIV/AIDS in Botswana and sub-Sahara Africa and quantifies its hazardous outcomes in terms of increased number of active TB cases and economic burden caused by increased need for AntiRetroviral Therapy (ART). Our simulations point to the heavy-drinking habits of men as a major reason for the continuing disproportionate impact of HIV/AIDS on women in sub-Sahara Africa. Our analysis has revealed the possibility of the phenomenon of backward bifurcation. In contrast to the result in some HIV vaccination models [52], backward bifurcation in our model is not removed by replacing the corresponding standard incidence function with a mass action incidence, but is removed by merging the two susceptible classes of the same sex into one, i.e., by ignoring acquisition of, and ongoing recovery from, heavy-drinking habits among the susceptible population.
Citation: Gigi Thomas, Edward M. Lungu. A two-sex model for the influence of heavy alcohol consumption on the spread of HIV/AIDS. Mathematical Biosciences & Engineering, 2010, 7 (4) : 871-904. doi: 10.3934/mbe.2010.7.871
References:
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References:
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A. B. Morris and I. P. Albery, Alcohol consumption and HIV risk behaviours: Integrating the theories of alcohol myopia and outcome-expectancies,, Addiction Research and Theory, 9 (2001), 73. doi: doi:10.3109/16066350109141773. Google Scholar

[2]

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[3]

A. O. Odejide, Status of drug use/abuse in Africa: A review,, Int. J. Ment. Health Addict., 4 (2006), 87. doi: doi:10.1007/s11469-006-9015-y. Google Scholar

[4]

A. Palepu, N. J. Horton, N. Tibbetts, S. Meli and J. H. Samet, Uptake and adherence to highly active antiretroviral therapy among HIV-infected people with alcohol and other substance use problems: The impact of substance abuse treatment,, Addiction, 99 (2004), 361. doi: doi:10.1111/j.1360-0443.2003.00670.x. Google Scholar

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B. C. Leigh, Alcohol and condom use a meta-analysis of event-level studies,, Sexually Transmitted Diseases, 29 (2002), 476. doi: doi:10.1097/00007435-200208000-00008. Google Scholar

[6]

B. C. Leigh and R. Stall, Substance use and risky sexual behavior for exposure to HIV: Issues in methodology, interpretation and prevention,, Am. Psychol., 48 (1993), 1035. doi: doi:10.1037/0003-066X.48.10.1035. Google Scholar

[7]

Centers for Disease Control and Prevention, Frequently asked questions,, available at , (). Google Scholar

[8]

Central Statistics Office, "Botswana AIDS Impact Survey III (BAIS III),", CSO, (2009). Google Scholar

[9]

Central Statistics Office, "Botswana Demographic Survey 2006,", CSO, (2009). Google Scholar

[10]

C. Emslie, H. Lewars, G. D. Batty and K. Hunt, Are there gender differences in levels of heavy, binge and problem drinking? Evidence from three generations in the west of Scotland,, Public Health, 123 (2009), 12. doi: doi:10.1016/j.puhe.2008.06.001. Google Scholar

[11]

C. F. Turner, H. G. Miller and L. E. Moses, "AIDS: Sexual Behavior and Intravenous Drug Use,", National Academy Press, (1989). Google Scholar

[12]

C. L. Mendenhall, Immunity, malnutrition and alcohol,, Alcohol Health & Research World, 16 (1992), 23. Google Scholar

[13]

D. A. Murphy, W. D. Marelich, D. Hoffman and W. N. Steers, Predictors of antiretroviral adherence,, AIDS Care, 16 (2004), 471. doi: doi:10.1080/09540120410001683402. Google Scholar

[14]

D. de Walque, Sero-discordant couples in five African countries: Implications for prevention strategies,, Population and Development Review, 33 (2007), 501. doi: doi:10.1111/j.1728-4457.2007.00182.x. Google Scholar

[15]

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[16]

E. J. Kovacs and K. A. N. Messingham, Influence of alcohol and gender on immune response,, Alcohol Research & Health, 26 (2002), 257. Google Scholar

[17]

E. Kip and R. Kubanji, Alcohol use among people living with HIV and AIDS: a study of Hukuntsi, Thamaga and Bobonong in Botswana,, in, (2009). Google Scholar

[18]

G. A. Roselle, Alcohol and the immune system,, Alcohol Health & Research World, 16 (1992), 16. Google Scholar

[19]

G. Szabo, Alcohol's contribution to compromised immunity,, Alcohol Health & Research World, 21 (1997), 30. Google Scholar

[20]

G. Thomas and E. M. Lungu, The influence of heavy alcohol consumption on HIV infection and progression,, Journal of Biological Systems, 17 (2009), 615. doi: doi:10.1142/S0218339009003083. Google Scholar

[21]

H. E. Hutton, M. E. McCaul, P. B. Santora and E. J. Erbelding, The relationship between recent alcohol use and sexual behaviors: Gender differences among STD clinic patients,, Alcoholism: Clinical & Experimental Research (ACER), 32 (2008), 2008. Google Scholar

[22]

I. W. Fong, S. Read, M. A. Wainberg, W. K. Chia and C. Major, Alcoholism and rapid progression to AIDS after seroconversion,, Clin. Infect. Dis., 19 (1994), 337. Google Scholar

[23]

J. J. Lewis, G. P. Garnett, S. Mhlanga, C. A. Nyamukapa, C. A. Donnelly and S. Gregson, Beer halls as a focus for HIV prevention activities in rural Zimbabwe,, Sexually Transmitted Diseases, 32 (2005), 364. doi: doi:10.1097/01.olq.0000154506.84492.61. Google Scholar

[24]

J. A. Flora and C. E. Thorensen, Reducing the risk of AIDS in adolescents,, American Psychologist, 43 (1988), 965. doi: doi:10.1037/0003-066X.43.11.965. Google Scholar

[25]

J. Conigliaro, A. J. Gordon, K. A. McGinnis, L. Rabeneck and A. C. Justice, How harmful is hazardous alcohol use and abuse in HIV infection: Do health care providers know who is at risk?,, Journal of Acquired Immune Deficiency Syndromes, 33 (2003), 521. Google Scholar

[26]

J. C. Fisher, P. A. Cook, N. E. Sam and S. H. Kapiga, Patterns of alcohol use, problem drinking, and HIV infection among high-risk African women,, Sexually Transmitted Diseases, 35 (2008), 537. doi: doi:10.1097/OLQ.0b013e3181677547. Google Scholar

[27]

J. C. Fisher, H. Bang and S. H. Kapiga, The association between HIV infection and alcohol use: A systematic review and meta- analysis of African studies,, Sexually Transmitted Diseases, 34 (2007), 856. doi: doi:10.1097/OLQ.0b013e318067b4fd. Google Scholar

[28]

J. C. Thompson, T. C. Kao and R. J. Thomas, The relationship between alcohol use and risk taking sexual behaviours in a large behavioural study,, Preventive Medicine, 41 (2005), 247. Google Scholar

[29]

J. H. Samet, N. J. Horton, S. Meli, K. A. Freedberg and A. Palepu, Alcohol consumption and antiretroviral adherence among HIV-infected persons with alcohol problems,, Alcohol Clin. Exp. Res., 28 (2004), 572. doi: doi:10.1097/01.ALC.0000122103.74491.78. Google Scholar

[30]

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