The effect of the needle exchange program on the spread of some sexually transmitted diseases

Abstract

In this paper we consider a model for the spread of a sexually transmitted disease considering sexual transmission and spread via infected needles among intravenous drug users. Besides the transmission among drug users, we also consider sexual contacts between intravenous drug users and non-drug users. Furthermore, the needles are considered as a vector population. For several European countries, a sharp increase of sexually transmitted diseases was reported and several others are rated as endangered based on the number of syringes given out per intravenous drug users per year. The main purpose of the paper is to investigate the dynamics of this model including the effect of needle exchange and study the risk of an increased transmission among non-drug users, induced by the reduction of the needle exchange program. Following the determination of the basic reproduction number R0 it is shown that all solutions tend to the unique disease-free equilibrium if R0 < 1. We also prove that the disease persists in the human population if R0 > 1. Our numerical simulations, based on real life and hypothetical data for HIV, suggest that a decrease in the rate of the distribution and discharge rate of new needles might imply that the considered disease is becoming endemic in the considered human population of drug users and non-drug users. A variant of our model with timevariable needle distribition parameter is fitted to recent HIV data from Hungary to give a forecast for the number of infected in the following years.