Modeling Detection of HIV in Cuba

A nonlinear compartmental model is developed for the HIV detection system in Cuba with different types of detections, some random and others non-random. We analyze the dynamics of this system, compute the reproduction numbers, and use the data from the Cuban HIV/AIDS epidemic between 1986-2008 to fit the model. We obtain estimates for the detection-related parameters during two separate time periods to reflect the timeline of the implementation of various types of searches. The reproduction numbers for each time period are also computed from the sets of values of the parameters. We found that random screening is most important as a mean of surveillance. Moreover, local asymptotic stability for the Disease Free Equilibrium can be achieved if (i) random screening is sufficiently effective and (ii) infection by detected HIV-positive individuals is minimal. Our results highlight the importance of education for the known infectious for the purpose of preventing further infection. Fitting the 1986-2008 HIV data to obtain the model parameter estimates indicates that the HIV epidemic in Cuba is currently approaching an endemic equilibrium. A Genetic Algorithm is used.