JSM 2005 - Toronto

Abstract #303353

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Legend: = Applied Session, = Theme Session, = Presenter
Activity Number: 99
Type: Contributed
Date/Time: Monday, August 8, 2005 : 8:30 AM to 10:20 AM
Sponsor: Biometrics Section
Abstract - #303353
Title: A Markov Model for Repeated Sexually Transmitted Infections
Author(s): Wanzhu Tu*+
Companies: Indiana University School of Medicine
Address: RG4101 1050 Wishard Boulevard, Indianapolis, IN, 46202, United States
Keywords: Markov model ; transmission probability ; linear model ; likelihood method
Abstract:

The primary focus of this research is to quantify the per exposure risk of sexually transmitted infection (STI). Toward this end, a cohort of young women were followed for seven months. Infection status was determined at each of the monthly followup visits. To estimate the per-exposure transmission risk, I propose a Markov model that takes into account the repeated STI tests and the behavior that might lead to the acquisition of a new infection. This model has a recursive structure that accommodates the effect of condom protection, the delivery of antibiotic treatment, and the probability of treatment failure. Other risk factors are incorporated via a linear model embedded in the Markov structure. Because of the recursive structure of the likelihood function, a new estimation procedure is developed to facilitate the model fitting. The proposed method is used to analyze three commonly seen bacterial STIs. Transmission risks of Chlamydia trachomatis, Trachomonas vaginalis, and Neisseria gonorrhea are established. A simulation study is used to assess operating characteristics of the proposed model.


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Revised March 2005