Social context and the spread of HIV: An evolutionary game-theoretic investigation on the impacts of social stigma on epidemic outcomes

William D. Ferguson*, Trang Kieu Nguyen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

We provide a theoretical foundation for analyzing how social stigma and adopted behavioral traits affect the transmission of HIV across a population. We combine an evolutionary game-theoretic model—based on a relationship signaling stage game— with the SIR (susceptible-infected-recovered) model of disease transmission. Our evolutionary model specifies how two types of social stigma—that which accompanies an HIV+ condition and that which follows associating with an HIV+ partner—influence behavioral propensities to honestly report one’s condition (or not) and to unconditionally accept relationships (or not). With respect to reporting an HIV+ condition, we find that condition stigma impedes the fitness of honest reporting, whereas association stigma impedes the relative fitness of concealing an HIV+ condition; and both propensities can coexist in a polymorphic equilibrium. By linking our model to the SIR model, we find that condition stigma unambiguously enhances disease transmission by discouraging both honest reporting and a society’s acceptance of AIDS education, whereas association stigma has an ambiguous impact: on one hand it can impede HIV transmission by discouraging concealing behavior and unconditional relationship acceptance, but it also compromises a society’s acceptance of AIDS education. Our relatively simple evolutionary/SIR model offers a foundation for numerous theoretical extensions—such as applications to social network theory—as well as foundation for many testable empirical hypotheses.

Original languageEnglish (US)
Pages (from-to)171-192
Number of pages22
JournalEconomies
Volume2
Issue number3
DOIs
StatePublished - Sep 2014

Keywords

  • Evolutionary game theory
  • HIV transmission
  • Polymorphic equilibrium
  • SIR model of disease transmission
  • Social stigma

ASJC Scopus subject areas

  • Development
  • Economics, Econometrics and Finance (miscellaneous)

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