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      Measuring concurrency using a joint multistate and point process model for retrospective sexual history data

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          Abstract

          Understanding the impact of concurrency, defined as overlapping sexual partnerships, on the spread of HIV within various communities has been complicated by difficulties in measuring concurrency. Retrospective sexual history data consisting of first and last dates of sexual intercourse for each previous and ongoing partnership is often obtained through use of cross-sectional surveys. Previous attempts to empirically estimate the magnitude and extent of concurrency among these surveyed populations have inadequately accounted for the dependence between partnerships and used only a snapshot of the available data. We introduce a joint multistate and point process model in which states are defined as the number of ongoing partnerships an individual is engaged in at a given time. Sexual partnerships starting and ending on the same date are referred to as one-offs and modeled as discrete events. The proposed method treats each individual’s continuation in and transition through various numbers of ongoing partnerships as a separate stochastic process and allows the occurrence of one-offs to impact subsequent rates of partnership formation and dissolution. Estimators for the concurrent partnership distribution and mean sojourn times during which a person has k ongoing partnerships are presented. We demonstrate this modeling approach using epidemiological data collected from a sample of men having sex with men and seeking HIV testing at a Los Angeles clinic. Among this sample, the estimated point prevalence of concurrency was higher among men later diagnosed HIV positive. One-offs were associated with increased rates of subsequent partnership dissolution.

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          Author and article information

          Journal
          8215016
          7188
          Stat Med
          Stat Med
          Statistics in medicine
          0277-6715
          1097-0258
          25 June 2016
          20 June 2016
          30 October 2016
          30 October 2017
          : 35
          : 24
          : 4459-4473
          Affiliations
          [a ]Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
          [b ]Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
          Author notes
          [* ]Correspondence to: Hilary Aralis, Department of Biostatistics, UCLA Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA. hilary.aralis@ 123456gmail.com
          Article
          PMC5054981 PMC5054981 5054981 nihpa791224
          10.1002/sim.7013
          5054981
          27324278
          a979cb57-5fd6-4bde-878c-fbfc195febeb
          History
          Categories
          Article

          multistate,concurrency,HIV,sexual history,point process
          multistate, concurrency, HIV, sexual history, point process

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