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PhD thesis

Subject

Prevention of infectious diseases in the context of effective treatment: a game-theoretic approach

Advisors

Romulus BREBAN (Institut Pasteur)

Virginie SUPERVIE (Inserm)

Abstract

My doctoral research concerns the mathematical modeling of infectious diseases transmission, taking into account the individuals' prevention versus treatment dilemma, the decision-making on whether or not to adopt prevention to avoid infection during an ongoing epidemic, in a context where efficient treatment is available. We aim to determine whether and under what conditions the voluntary adoption of prevention could avert an epidemic.

We propose a mathematical model that combines disease transmission at the population level with decision-making at the individual level. We model disease transmission using a compartmental model defined by a system of ordinary differential equations. For the individual-level decision-making, we propose a game-theoretic approach, which assumes that individuals solve the prevention versus treatment dilemma by choosing the strategy that benefits them the most, in the long term. Individuals adopt a proposed prevention strategy provided that it is perceived as more beneficial than treatment. The decision-making thus depends on the individuals' perception of their risk of infection, as well as on their perception of the relative cost of prevention versus treatment, which includes monetary and/or non-monetary aspects such as price, reimbursement policies, accessibility, social stigma, disease morbidity, undesired secondary effects, etc.

We explore two cases of the dilemma of prevention versus treatment. First, we address voluntary vaccination in the context of preventable and treatable childhood infectious diseases. In particular, we apply our methods and findings to the epidemiology of measles. Second, we study the voluntary adoption of pre-exposure prophylaxis to avoid HIV infection by the individuals who are most at risk. In particular, we analyze the HIV epidemiology among one of the populations most at risk in France: men who have sex with men in the Paris region.

Keywords. Behavioral epidemiology; Voluntary prevention; Epidemic elimination; Game theory; Compartmental model.

Publications

Jijon et al., Vaccine, 2017 (Application to vaccination)

Jijon et al., AIDS, 2021 (Application to PrEP)

Defense

July 5, 2021, Paris, France

Jury: Chris BAUCH (University of Waterloo; Referee), Raffaele VARDAVAS (RAND Corporation; Referee), Alberto D'ONOFRIO(IPRI; Examinor), Judith MUELLER (Institut Pasteur; Examinor) and Sylvain SORIN (Sorbonne Université; Examinor)

Defense slides

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