The Influence of Behavioural Heterogeneity on the Population Level Effect of Potential Prophylactic Human Immunodeficiency Virus Type 1 Vaccines

Abstract
Summary: Theoretical results indicate that extensive coverage with low efficacy type 1 human immunodeficiency virus (HIV) vaccines could substantially reduce the incidence of HIV in developing countries. There is a non-linear relationship between effective vaccine coverage and HIV prevalence such that improved efficacy brings diminishing returns. The relative contribution of HIV-associated mortality and behavioural heterogeneity to this non-linear relationship is explored using deterministic mathematical models. If the duration of risk of acquiring HIV is long relative to the HIV incubation period then infection-associated mortality can generate the non-linear relationship. However, in its absence the same relationship results from behavioural heterogeneity. Models of HIV vaccination alongside other interventions generate qualitative results that suggest that targeted interventions lead to less redundancy in control efforts.

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