Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review Article
  • Published:

The spread of HIV-1 in Africa: sexual contact patterns and the predicted demographic impact of AIDS

Abstract

The spread of HIV-1 in Africa is examined here in the light of recent information on the main epidemiological and behavioural determinants of transmission. Mathematical models incorporating demographic, epidemiological and behavioural processes are used to assess the potential demographic impact of the disease AIDS. These analyses highlight the significance of patterns of sexual behaviour, and in particular networks of sexual contact, on the predicted spread of infection. Current data reveal substantial variations in the degree of spread between and in countries, but new analyses support earlier predictions that in the worst-afflicted areas AIDS is likely to change population growth rates from positive to negative values in a few decades.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type

from$1.95

to$39.95

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Gottlieb, M. S. et al. New Engl. J. Med. 305, 1425–1431 (1981).

    Article  CAS  Google Scholar 

  2. Barre-Sinoussi, F. et al. Science 220, 868–871 (1988).

    Article  ADS  Google Scholar 

  3. Gallo, R. C. et al. Science 224, 497–500 (1984).

    Article  ADS  Google Scholar 

  4. De Cock, K. M. et al. Science 249, 793–796 (1990).

    Article  ADS  CAS  Google Scholar 

  5. Ryder, R. W. et al. New Engl. J. Med 320, 1658–1642 (1989).

    Article  Google Scholar 

  6. Centers for Disease Control National HIV Seroprevalence Surveys 1–26 (US Department of Health and Human Services, 1990).

  7. Des Jarlais, D. C. et al. J. Am. med. Ass. 261, 1008–1012 (1989).

    Article  CAS  Google Scholar 

  8. Vanichseni, S. et al. V Int. Conf. AIDS Montreal 6/4-9 Poster TGO 23 (1989).

  9. John, J.T., Babu, G.P., Jayakumari, H. & Simoes, E.A.F. Lancet i, 160–161 (1989).

    Google Scholar 

  10. Biggar, R. J. AIDS 4, 1059–1066 (1990).

    Article  CAS  Google Scholar 

  11. Goodenow, M. et al. J. AIDS 2, 344–352 (1989).

    CAS  Google Scholar 

  12. Wellings, K. et al. Nature 348, 276–278 (1990).

    Article  ADS  CAS  Google Scholar 

  13. Anzala, A. et al. V Int. Conf. AIDS Montreal abstract A025 (1989).

  14. N'galy, B. & Ryder, R. W. J. AIDS 1, 551–558 (1988).

    CAS  Google Scholar 

  15. Rogers, M. F. et al. Pediatrics 79, 1008–1014 (1987).

    CAS  PubMed  Google Scholar 

  16. Taylor, J. M. G., Kwo, J. M. & Detels, R. J. AIDS 4, 69–75 (199).

    Google Scholar 

  17. Goodenow, M. et al. J. AIDS 2, 344–352 (1989).

    CAS  Google Scholar 

  18. Nowak, M., May, R. M. & Anderson, R. M. AIDS 4, 1095–1103 (1990).

    Article  CAS  Google Scholar 

  19. Hira, S. K. et al. Br. med. J. 299, 1250–1253 (1989).

    Article  CAS  Google Scholar 

  20. Italian Multicentre Study Lancet i, 1043–1045 (1988).

  21. Blanche, S. et al. New Engl. J. Med. 320, 1643–1648 (1989).

    Article  CAS  Google Scholar 

  22. European Collaborative Study Lancet i, 253–259 (1991).

  23. Scott, G. B. et al. New Engl. J. Med. 321, 1791–1796 (1989).

    Article  CAS  Google Scholar 

  24. Ryder, R. W. et al. AIDS 4, 725–732 (1990).

    Article  CAS  Google Scholar 

  25. Berkley, S. et al. AIDS 4, 1237–1242 (1990).

    Article  CAS  Google Scholar 

  26. Brown, R. C. AIDS 4, 1267–1270 (1990).

    Article  CAS  Google Scholar 

  27. Anderson, R. M., May, R. M. & McLean, A. R. Nature 332, 191–290 (1988).

    Article  Google Scholar 

  28. Levy, J. A. AIDS 4, 1051–1058 (1990).

    Article  CAS  Google Scholar 

  29. Piot, P. & Laga, M. Br. med. J. 298, 623–624 (1989).

    Article  CAS  Google Scholar 

  30. Konings, E., Anderson, R. M., Morley, D. & Meegan, M. AIDS 3, 245–247 (1989).

    CAS  PubMed  Google Scholar 

  31. Anderson, R. M., May, R. M., Ng, W., Rowley, J. T. Phil. Trans. Roy. Soc. B (in the press).

  32. Carael, M., Cleland, J. & Odeokun, L. AIDS (in the press.)

  33. Hogsborg, M. & Aaby, P. in Anthropological Studies Relevant to the Sexual Transmission of HIV (International Union for the Scientific Study of Population, Liege, in the press).

  34. Potts, M., Anderson, R. M. & Boiley, M. C. Lancet (in the press).

  35. Anderson, R. M., Ng, W., Boily, M. C. & May, R. M. N.Y. Acad. Sci. 569, 240–274 (1989).

    Article  ADS  CAS  Google Scholar 

  36. Anderson, R. M. & May, R. M. Nature 333, 514–522 (1988).

    Article  ADS  CAS  Google Scholar 

  37. Hyman, J. M. & Stanley, E. A. Math. Biosci. 90, 415–474 (1988).

    Article  MathSciNet  Google Scholar 

  38. Bongaarts, J. Stats. Med. 8, 103–120 (1989).

    Article  CAS  Google Scholar 

  39. Jacquez, J. A., Simon, C. P., Koopman, J. et al. Math. Biosci. 92, 119–199 (1988).

    Article  MathSciNet  Google Scholar 

  40. Gupta, S., Anderson, R. M. & May, R. M. AIDS 3, 1–11 (1989).

    Article  Google Scholar 

  41. Sharp, P. M. & Li, W. H. Nature 336, 315 (1988).

    Article  ADS  CAS  Google Scholar 

  42. Yokoyama, S., Chung, L. & Gojobori, T. Molec. biol. Evol. 5, 237–251 (1988).

    CAS  PubMed  Google Scholar 

  43. May, R. M. & Anderson, R. M. Parasitology 100, S89–S101 (1990).

    Article  Google Scholar 

  44. May, R. M., Anderson, R. M. & McLean, A. R. Math. Biosci. 90, 475–505 (1988).

    Article  MathSciNet  Google Scholar 

  45. May, R. M., Anderson, R. M. & McLean, A. R. Lect. Notes Biomath. 81, 220–248 (1988).

    Article  Google Scholar 

  46. Kreiss, J., Carael, M. & Mehous, A. Genitourin. Med. 64, 1–2 (1988).

    CAS  PubMed  PubMed Central  Google Scholar 

  47. May, R. M. & Anderson, R. M. in Current Topics in AIDS Vol. 2 33–68 (Wiley, New York, 1989).

    Google Scholar 

  48. Rowley, J. T., Anderson, R. M. & Ng, T. W. AIDS 4, 47–56 (1990).

    Article  CAS  Google Scholar 

  49. HIV/AIDS Surveillance Data Base 9th update (US Bureau of the Census, Washington DC, 1990).

  50. Andreasson, P. et al. V Int. Conf. AIDS Montreal 6/4-9 poster MGP 16 (1989).

  51. Gnaore, E. et al. VI Int. Conf. on AIDS San Francisco 6/20-24 poster FC663 (1990).

  52. Mati, J. et al. VI Int. Conf. AIDS San Francisco 6/20-24 poster (1990).

  53. Liomba, N. G. et al. V Int. Conf. AIDS Montreal 6/4-9 poster WGO 29 (1989).

  54. Maiga, M. K. et al. V Int. Conf. AIDS Montreal 6/4-9 abstract A577 (1989).

  55. HIV Seroprevalence: Blood-Bank, Mozambique (Ministry of Health (Mozambique), 1989).

  56. Le Page, P. et al. IV Int. Conf. AIDS and Associated Cancers in Africa Marseille poster 243 (1989).

  57. Killewo, J. et al. AIDS 4, 1081–86 (1990).

    Article  CAS  Google Scholar 

  58. Guay, L. et al. VI Int. Conf. AIDS San Francisco 6/20-24 poster (1990).

  59. Murile, A. V Int. Conf. AIDS Montreal 6/4-9 abstract TBP 353 (1989).

  60. Piot, P. et al. J. infect. Dis. 155, 1108–1112 (1987).

    Article  CAS  Google Scholar 

  61. Lifoon, A. R. et al. VI Int. Conf. AIDS San Francisco abstract C33 (1990).

  62. Ward, J. et al. IV International Conference on AIDS Stockholm abstract 7711 (1988).

  63. Giezecke, J. et al. Br. med. J. 297, 99–102 (1988).

    Article  Google Scholar 

  64. Rezza, G. et al. AIDS 3, 87–90 (1989).

    Article  CAS  Google Scholar 

  65. Auger, I. et al. Nature 336, 575–577 (1988).

    Article  ADS  CAS  Google Scholar 

  66. European Collaborative Study Lancet ii, 1039–1042 (1988).

  67. Fischl, M. A. et al. J. Am. med. Ass. 257, 640–644 (1987).

    Article  CAS  Google Scholar 

  68. European Study Group Br. med. J. 298, 411–415 (1989).

  69. Padian, N. et al. J. Am. med. Ass. 258, 788–791 (1987).

    Article  CAS  Google Scholar 

  70. Glaser, J. B., Strange, T. J. & Rosati, D. Archs intern. Med. 149, 645–649 (1989).

    Article  CAS  Google Scholar 

  71. Johnson, A. M. et al. AIDS 3, 367–372 (1989).

    Article  CAS  Google Scholar 

  72. Peterman, T. A., Stoneburner, R. L., Allen, J. R., Jaffe, H. W. & Curran, J. W. J. Am. med. Ass. 259, 55–58 (1988).

    Article  CAS  Google Scholar 

  73. Hewlett, I. K. et al. J. AIDS 3, 714–720 (1990).

    CAS  Google Scholar 

  74. France, A. J. et al. Br. med. J. 296, 526–529 (1988).

    Article  CAS  Google Scholar 

  75. Centres for Disease Control Morbidity and Mortality Weekly Reports 36, 593–595 (1987).

  76. Biberfield, G. et al. Scand. J. infect. Dis. 18, 497–500 (1986).

    Article  Google Scholar 

  77. Andinan, W. A. et al. AIDS 4, 758–766 (1990).

    Google Scholar 

  78. Goedert, J. J. et al. Lancet ii, 1351–1354 (1989).

    Article  Google Scholar 

  79. Reeves, G. K. Phil. Trans. R. Soc. B 325, 109–114 (1989).

    Article  Google Scholar 

  80. Rothenberg, R. et al. New Engl. J. Med. 317, 1297–1302 (1987).

    Article  CAS  Google Scholar 

  81. Anderson, R. M. J. statist. Soc. A 151, 66–93 (1988).

    Article  Google Scholar 

  82. Blower, S. M., Anderson, R. M. & Wallace, P. J. AIDS 3, 763–772 (1990).

    CAS  Google Scholar 

  83. Baldwin, J. D. & Baldwin, J. I. J. Sex Res. 1, 181–196 (1988).

    Article  Google Scholar 

  84. Hudson, C. P. et al. AIDS 2, 255–260 (1988).

    Article  CAS  Google Scholar 

  85. Van de Perre, P. et al. Lancet ii, 524–527 (1985).

    Article  Google Scholar 

  86. Berkley, S. F. et al. IV Int. Conf. AIDS and Associated Cancers in Africa Marseille 1989 poster 012 (1989).

  87. Melbye, M. et al. Lancet i, 1113–1115 (1986).

    Article  Google Scholar 

  88. Lisse, I. M. et al. AIDS 4, 1263–1266 (1990).

    Article  CAS  Google Scholar 

  89. Thangcharven, P. et al. HIV Infection in Thailand (Mahidol University Publication, Bangkok, 1989).

    Google Scholar 

  90. Ntozi, J. P. M. & Lubega, M. in Anthropological Studies Relevant to the Sexual Transmission of HIV (International Union for the Scientific Study of Population, Liege, in the press).

  91. Boily, M. C. & Anderson, R. M. IMA J. math. Med. Biol. (in the press).

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Anderson, R., May, R., Boily, M. et al. The spread of HIV-1 in Africa: sexual contact patterns and the predicted demographic impact of AIDS. Nature 352, 581–589 (1991). https://doi.org/10.1038/352581a0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1038/352581a0

This article is cited by

Comments

By submitting a comment you agree to abide by our Terms and Community Guidelines. If you find something abusive or that does not comply with our terms or guidelines please flag it as inappropriate.

Search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing