Long-Term Projections of the AIDS Epidemic

A mathematical model for predicting the future course of the AIDS epidemic permits the evaluation of a number of possible scenarios for male homosexuals in the US and finds that, while the epidemic can be mitigated, a combination of strategies will probably be needed. Steps to lower the transmissibility of the virus and to encourage more widespread testing and abstinence from risky sex practices are the most promising; merely reducing the rate of acquisition of new sexual partners without decreasing total sexual activity will have only a minor impact. A drug that increases the time from initial infection to the development of AIDS and the time from development of AIDS to death improves the short-term situation at the expense of the long-term if no cure is found. The presence of such a drug in conjunction with the other interventions is, in certain ways, worse than its absence. The model is used to estimate that between 24 and 52 new large urban hospitals will be needed to accommodate male homosexual AIDS patients, perhaps as soon as 1997.