Modelling HIV and hepatitis C among injecting drug users in Australia and HIV among risk groups in Indonesia: projection and cost-effectiveness analysis

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Copyright: Kwon, Jisoo Amy
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Abstract
Mathematical models are useful tools for understanding complex dynamical systems, such as infectious disease epidemics. This thesis aims to apply techniques of mathematical modelling to the studies of HIV and hepatitis C epidemiology in Australia and Indonesia particularly focused on viral transmission with intravenous drug use. This thesis is divided into five chapters. Chapter 2 formulates a predictive relationship between NSPs and the risk of HIV/HCV transmission among PWID, calibrated to reflect incidence among PWID in Australia. This static mathematical model is developed to estimate how changes in sterile syringe distribution through NSPs may affect HIV and HCV incidences among PWID in Australia. Chapter 3 presents costeffectiveness and return on investment analyses of NSPs with respect to HIV/HCV infections among Australian PWID. A graphical user interface around a new mathematical model developed to estimate HIV transmission in Indonesia and evaluate past and project intervention impact is described in Chapter 4. The interface was applied to various risk and geographical populations in Indonesia in order to match HIV prevalence data, and coverage of antiretroviral therapy (ART). Trends in the expected HIV incidence both overall and in each population group are calculated. Chapter 5 presents a cost-effectiveness analysis of ART expansion in Indonesia. In this chapter, the analysis is used to estimate an economically optimal ART expansion strategy for reducing HIV infections among high-risk populations in Indonesia. The impact of increasing ART coverage and expansion of treatment-eligible criteria are assessed. Chapters 2 and 3 of this thesis are published in international journals. Chapter 4 is published as a report to the Indonesian government. Chapter 5 is yet to be published but is in the process of submission to an international journal.
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Author(s)
Kwon, Jisoo Amy
Supervisor(s)
Wilson, David P
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Publication Year
2012
Resource Type
Thesis
Degree Type
PhD Doctorate
UNSW Faculty
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