We evaluate the potential impact of rectal microbicides for reducing HIV transmission in bathhouses. A new mathematical model describing HIV transmission dynamics among men who have sex with men (MSM) in bathhouses is constructed and analyzed. The model incorporates key features aﬀecting transmission, including sexual role behavior (insertive and receptive anal intercourse acts), biological transmissibility of HIV, frequency and eﬃcacy of condom usage, and, most pertinently, frequency and eﬃcacy of rectal microbicide usage. To evaluate the potential impact of rectal microbicide usage, we quantify the eﬀect of rectal microbicides (ranging in eﬃcacy from 10% to 90%) on reducing the number of HIV infections in the bathhouse. We conduct uncertainty analyses to assess the eﬀect of variability in both biological and behavioral parameters. We ﬁnd that even moderately eﬀective rectal microbicides (if used in 10% to 50% of the sex acts) would substantially reduce transmission in bathhouses. For example, a 50% eﬀective rectal microbicide (used in 50% of sex acts) would reduce the number of secondary infections by almost 13% at disease invasion. Our modeling analyses show that even moderately eﬀective rectal microbicides could be very eﬀective prevention tools for reducing transmission in bathhouses and also potentially limit the spread of HIV in the community.
Available at: http://works.bepress.com/chad_topaz/5/