Using mathematical modelling to investigate the plausibility of attributing observed antenatal clinic declines to a female sex worker intervention in Karnataka state, India
Bibliographic record
Abstract
OBJECTIVES: To determine whether the 32% and 52% decline in ANC HIV prevalence among female antenatal clinic (ANC) attenders, observed in Avahan districts between 2004 and 2006, and 2007 respectively, in the state of Karnataka could be due to a HIV preventive intervention targeted at female sex workers and their clients. METHODS: An exhaustive sensitivity analysis, based on an age and parity structured mathematical model of HIV transmission in a general and ANC population, was undertaken to estimate intervention impact in different concentrated HIV epidemics representative of those in Karnataka districts. To assess if the large reduction in ANC HIV prevalence could be solely due to the intervention, we simulated a very optimistic intervention. RESULTS: If 100% of FSWs were reached and condom use between clients and FSWs increased instantaneously to over 80% of sex acts, the expected intervention decline (50th, (10th, 90th) percentiles) among the overall and 15-19 year old ANC population after three years of intense intervention activity was 21% (14%, 27%) and 27% (19%, 35%); with a predicted time required to produce a 30% intervention decline being approximately 5 (4.0, 6.4) and approximately 3.6 (2.8, 4.8) years, respectively. To achieve this magnitude of decline, the client and FSW HIV prevalence needed to decrease by 33% (28%, 38%) and 44% (38%, 50%), respectively, after three years. CONCLUSION: Despite the optimistic prevention parameters assumed, our results suggest that the large observed changes in ANC HIV prevalence are very unlikely to already be entirely caused by the FSW targeted intervention. Interpretation of HIV trends in ANC populations should involve triangulation of observed biological and behavioural trends in high-risk groups, modeling studies and documentation of possible sources of bias.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".