A method for assessing the global spread of HIV‐1 infection based on air travel

Abstract

The paper presents a methodology aimed at quantifying the impact of regular air traffic on the global spread of AIDS. A compartmental approach is used to represent the fluxes of infective passengers between 52 major cities. The impact of these fluxes on the pandemic is assessed by using a methodology which has been applied in the past for studying the dynamic of an influenza pandemic. In its present version, under simplified asumptions, the model reproduces qualitatively the three world patterns of HIV‐1 infection in 1988. The methodology developed in this paper does not provide a detailed past history of the virus, and does not take into account the possibility of multifoci sporadic cases in the past. However it provides evidence that the significant start of the pandemic (defined as the time when at least 100 infected persons were present in the same city) was by the end of the 60's in Central Africa. Projecting the model to 1994 predicts that the epidemic will increase quickly in all the cities where the prevalence is already high. For examples, prevalence in the population of Kinshasa will be 8 percent in 1994; Lagos, 6 percent; New York City, 2.5 percent In some Asian and in Eastern European cities, the prevalence would rapidly exceed the 1980 Western European levels (in the range clearly above 0.20 percent). In Asia, these cities are Bangkok (0.5%), Hong Kong (1%), Singapore (0.8%), Tokyo (1%), and Manila (1%). The method may be used to assist in forecasting the trends of future epidemics in places where AIDS or HIV infection prevalence (or incidence) are not well known.