Forecasting the Effect of Pre-Exposure Prophylaxis (PrEP) on HIV Propagation with a System of Differential–Difference Equations with Delay

Abstract

The HIV/AIDS epidemic is still active worldwide with no existing definitive cure. Based on the WHO recommendations stated in 2014, a treatment, called Pre-Exposure Prophylaxis (PrEP), has been used in the world, and more particularly in France since 2016, to prevent HIV infections. In this paper, we propose a new compartmental epidemiological model with a limited protection time offered by this new treatment. We describe the PrEP compartment with an age-structure hyperbolic equation and introduce a differential equation on the parameter that governs the PrEP starting process. This leads us to a nonlinear differential–difference system with discrete delay. After a local stability analysis, we prove the global behavior of the system. Finally, we illustrate the solutions with numerical simulations based on the data of the French Men who have Sex with Men (MSM) population. We show that the choice of a logistic time dynamics combined with our Hill-function-like model leads to a perfect data fit. These results enable us to forecast the evolution of the HIV epidemics in France if the populations keep using PrEP.

Keywords

• HIV
• AIDS
• PrEP
• differential–difference system
• discrete delay
• France