Modelling Botswana's HIV/AIDS response and treatment policy changes: Insights from a cascade of mathematical models

Tefa Kaisara; Farai Nyabadza; Tefa Kaisara; Farai Nyabadza

doi:10.3934/mbe.2023052

Mathematical Biosciences and Engineering

2023, Volume 20, Issue 1: 1122-1147. doi: 10.3934/mbe.2023052

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Modelling Botswana's HIV/AIDS response and treatment policy changes: Insights from a cascade of mathematical models

Tefa Kaisara ^1,2,
Farai Nyabadza ^{1
,
,}

1.
University of Johannesburg, Department of Mathematics and Applied Mathematics, P.O. Box 524, Auckland Park, 2006, South Africa
2.
Botswana International University of Science and Technology, Department of Mathematics and Statistical Sciences, Private Bag 16, Palapye, Botswana

Received: 23 November 2021 Revised: 07 September 2022 Accepted: 19 September 2022 Published: 26 October 2022

The management of HIV/AIDS has evolved ever since advent of the disease in the past three decades. Many countries have had to revise their policies as new information on the virus, and its transmission dynamics emerged. In this paper, we track the changes in Botswana's HIV/AIDS response and treatment policies using a piece-wise system of differential equations. The policy changes are easily tracked in three epochs. Models for each era are formulated from a "grand model" that can be linked to all the epochs. The grand model's steady states are determined and analysed in terms of the model reproduction number, $ R_{0}. $ The model exhibits a backward bifurcation, where a stable disease-free equilibrium coexists with a stable endemic equilibrium when $ R_{0} < 1. $ The stability of the models for the other epochs can be derived from that of the grand model by setting some parameters to zero. The models are fitted to HIV/AIDS prevalence data from Botswana for the past three decades. The changes in the populations in each compartment are tracked as the response to the disease and treatment policy changed over time. Finally, projections are made to determine the possible trajectory of HIV/AIDS in Botswana. The implications of the policy changes are easily seen, and a discussion on how these changes impacted the epidemic are articulated. The results presented have crucial impact on how policy changes affected and continue to influence the trajectory of the HIV/AIDS epidemic in Botswana.
- HIV/AIDS,
- Grand model,
- reproduction number,
- treatment policy,
- fitting,
- simulations
Citation: Tefa Kaisara, Farai Nyabadza. Modelling Botswana's HIV/AIDS response and treatment policy changes: Insights from a cascade of mathematical models[J]. Mathematical Biosciences and Engineering, 2023, 20(1): 1122-1147. doi: 10.3934/mbe.2023052

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Abstract

The management of HIV/AIDS has evolved ever since advent of the disease in the past three decades. Many countries have had to revise their policies as new information on the virus, and its transmission dynamics emerged. In this paper, we track the changes in Botswana's HIV/AIDS response and treatment policies using a piece-wise system of differential equations. The policy changes are easily tracked in three epochs. Models for each era are formulated from a "grand model" that can be linked to all the epochs. The grand model's steady states are determined and analysed in terms of the model reproduction number, $ R_{0}. $ The model exhibits a backward bifurcation, where a stable disease-free equilibrium coexists with a stable endemic equilibrium when $ R_{0} < 1. $ The stability of the models for the other epochs can be derived from that of the grand model by setting some parameters to zero. The models are fitted to HIV/AIDS prevalence data from Botswana for the past three decades. The changes in the populations in each compartment are tracked as the response to the disease and treatment policy changed over time. Finally, projections are made to determine the possible trajectory of HIV/AIDS in Botswana. The implications of the policy changes are easily seen, and a discussion on how these changes impacted the epidemic are articulated. The results presented have crucial impact on how policy changes affected and continue to influence the trajectory of the HIV/AIDS epidemic in Botswana.

References

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