Participatory System Dynamics Modeling to Address HIV infection

Margaret R. Weeks, Ph.D. Institute for Community Research, Hartford, CT; David Lounsbury, Albert Einstein College of Medicine, NYC.

This is a system dynamics (SD) model of the HIV Care Continuum. The model is designed to simulate HIV "treatment as prevention" to help eliminate the epidemic. Contributing to this central goal are the basic testing, medical care, case management, and support services found in most communities. The model also includes community-level interventions (action strategies) to improve service effectiveness, such as peer testing and advocacy programs, expanded primary care to focus on comprehensive sexual health screening, and community initiatives to increase HIV awareness, support families of people living with HIV (PLWH), and reduce HIV stigma and medical mistrust.

The model was created by an anthropology/psychology/systems modeling team in collaboration with a steering committee of 25 HIV providers and advocates, users, and a larger network of HIV activists, service personnel and planners. It is designed to help community members understand how system feedback, delays, and other complex dynamics affect the functioning of the HIV Care Continuum that is expected to reduce or eliminate the HIV epidemic while caring for all people living with HIV/AIDS (PLWH).

This SD model can be used to learn about the dynamics of an HIV care system through the “base case simulation run” using original data from a three-county area in Connecticut. Model users can also test different “What if?” scenarios to identify which changes in resources and actions, or combinations of these, generate best improvements to the system. Model users can also tailor the model to their own community’s epidemic and local services to better understand the challenges and opportunities to improve the HIV Care Continuum system in their region. The model was created with Stella Architect Software. You can learn more and test the model by following the link below:

To watch a video demonstration of how to use the model, use the link above for the model and click on the “Audio Model Instructions” button, or click the link below:

For an overview of the model see manual at this link:
Background and Resources text for website 2020Sep18.pdf - Google Drive

Community Viral Load SD model development and application publications:

Weeks, M.R., Li, J., Lounsbury, D., Green, H.D., Berman, M., Rohena, L., Gonzalez, R., Lang, S., Mosher, H.I. (2017). Using participatory system dynamics modeling to examine the local HIV test and treatment care continuum in order to reduce community viral load. American Journal of Community Psychology, 60 (3-4): 584-598. PMID: 29154393; PMCID: PMC5729085.

Weeks, M.R., Lounsbury, D.W., Li, J., Hirsch, G., Berman, M., Green, H.D., Rohena, L., Gonzalez, R., Montezuma-Rusca, J.M., Jackson, S. (2020). Simulating system dynamics of the HIV care continuum to achieve treatment as prevention. PLOS ONE. 2020 Mar 19;15(3):e0230568. doi: 10.1371/journal.pone.0230568. eCollection 2020. PMID: 32191771 PMCID: PMC7082036.

Weeks, M.R., Lounsbury, D.W., Li, J., Green, H.D., Berman, M., Rohena, L., Gonzalez. R., Mosher, H.I., & Hirsch, G. System Dynamics (SD) Model of the HIV Care Continuum: Model Protocol (V.2). March 20, 2020.

Weeks, M.R., Green Montaque, H.D., Lounsbury, D.W., Li, J., Ferguson, A., and Warren-Dias, D. (2022) Using participatory system dynamics learning to support Ryan White Planning Council priority setting and resource allocations. Evaluation and Program Planning, 93: August:102104.

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Governments at all levels are beginning to recognize the value of low-cost tools and open science hardware for more holistic and comprehensive environmental monitoring, and in many cases are even promoting their development and use in and by local communities. This blog explains the context for this growing trend and some tools that are readily available for use by communities to measure air and water quality. See blog at this link: