Number of sex acts matters for heterosexual transmission and control of Chlamydia trachomatis

Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
Laboratoire MIVEGEC (UMR CNRS 5290, IRD 224, UM1, UM2), 34394 Montpellier Cedex 5, France
Oxford University Clinical Research Unit, Hanoi, Vietnam
DOI
10.7287/peerj.preprints.940v1
Subject Areas
Computational Biology, Mathematical Biology, Epidemiology, Infectious Diseases, Statistics
Keywords
sexual mixing, infection control, Chlamydia trachomatis, parameter inference, mathematical model
Copyright
© 2015 Althaus et al.
Licence
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ PrePrints) and either DOI or URL of the article must be cited.
Cite this article
Althaus CL, Choisy M, Alizon S, the CSF group. 2015. Number of sex acts matters for heterosexual transmission and control of Chlamydia trachomatis. PeerJ PrePrints 3:e940v1

Abstract

Mathematical models are instrumental in controlling Chlamydia trachomatis and other sexually transmitted infections (STIs). Modeling approaches that stratify the population by the number of individuals' sex partners often assume the transmission risk per partner to be constant. Sexual behavior data shows, however, that people with many partners share less sex acts per partner than people with fewer partners. This should lower the risk of transmission per partner for highly sexually active individuals and could have important epidemiological consequences for STI transmission and the projected impact of control scenarios. We devise a new epidemiological model that we fit to chlamydia prevalence data from Natsal-2 and CSF, two population-based probability sample surveys of sexual behavior in Britain and France. Compared to a standard model where the transmission risk per partner is constant, a model with realistic numbers of sex acts per partner provides a better fit to the data. Furthermore, the improved model provides evidence for strong assortative mixing among individuals with different numbers of sex partners. Our results suggest that all chlamydia infected individuals with one or more new heterosexual partners per year contribute to ongoing transmission, underlining that control interventions should be aimed towards all sexually active young adults.

Author Comment

The CSF group is composed of Nathalie Bajos and Michel Boson (scientific heads), Nathalie Beltez (coordinator), Armelle Andro, Michele Ferrand, Veronique Goulet, Anne Laporte, Henri Leridon, Charlotte Le Van, Sharman Levinson, Laurent Toulemon, Nicolas Razandrastima, Josiane Warszawski, and also Lucette Aussel and Caroline Laborde. This manuscript will be submitted elsewhere.