Adding Education to “Test and Treat”: Can We Overcome Drug Resistance?

Abstract

Recent mathematical modelling has advocated for rapid “test-and-treat” programs for HIV in the developing world, where HIV-positive individuals are identified and immediately begin a course of antiretroviral treatment, regardless of the length of time they have been infected. However, the foundations of this modelling ignored the effects of drug resistance on the epidemic. It also disregarded the heterogeneity of behaviour changes that may occur, as a result of education that some individuals may receive upon testing and treatment. We formulate an HIV/AIDS model to theoretically investigate how testing, educating HIV-positive cases, treatment, and drug resistance affect the HIV epidemic. We consider a variety of circumstances: both when education is included and not included, when testing and treatment are linked or are separate, when education is only partly effective, and when treatment leads to drug resistance. We show that education, if it is properly harnessed, can be a force strong enough to overcome the effects of antiretroviral drug resistance; however, in the absence of education, “test and treat” is likely to make the epidemic worse.

Mathematical modeling for relation between parents' health education and vaccine uptake

“…Also our results agree with the results of Garira and Tchuenche 17 that the combination of control measures should include education to ensure best disease control. Finally, we have proved that both early and late education are important in reducing the number of infected cases, which agrees with Al‐arydah and Smith 16 …”

“…Gutiérrez‐Jara et al 15 investigate how different social behaviors and restrictive measures affect the COVID‐19 dynamic within a population based on a mathematical approach of the Susceptible‐Exposed‐Asymptomatic‐Infectious‐Recovered‐Susceptible model with quarantine and social distance‐dependent transmission rates. Al‐arydah and Smith 16 investigate the efficiency of education in improving the test and treat program and reducing drug‐resistance HIV cases. Education was used there as a key tool to change the risky behavior of HIV‐positive cases and increase adherence to treatment, which reduced drug‐resistance cases.…”

Population Modelling by Examples II

“…The mathematical model that was used was flawed [7], but the World Health Organisation adopted it anyway and began this widescale program. Our modelling took the original model but added in both drug resistance and also education (manifested through behaviour changes) [8]. We showed that, in the absence of education but with drug resistance included, then the "test and treat" program was highly likely to make matters worse, leading to widespread treatment failure down the line.…”

A Comparative Study Between Two Systems with and Without Awareness in Controlling HIV/AIDS

“…A similar approach was considered earlier by Hyman et al (2003) with differential infectivity and staged progression models. Al-arydah and Smith (2015) considered a model where they investigated how testing, educating HIV-positive cases, treatment and drug resistance affects the HIV epidemic. Kiss et al (2010) proposed a model for a totally aware closed population where the individuals are discriminated according to their response towards the information available.…”