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Research Article Volume 14 Issue 2
Modelling progression in HIV/AIDS antiretroviral intake stages in Akwa Ibom State using markov decision process and survival analysis
Iseh Matthew Joshua, Matthew Michael Aloysius, Mandu Otto Inyang
Received: August 16, 2025 | Published: October 8, 2025
Citation: Joshua IM, Aloysius MM, Inyang MO. Modelling progression in HIV/AIDS antiretroviral intake stages in Akwa Ibom State using markov decision process and survival analysis. Biom Biostat Int J. 2025;14(2):68-75. DOI: 10.15406/bbij.2025.14.00436
Abstract
Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) continues to be a substantial public health concern, especially in areas with high rates of occurrence. In recent time, Antiretroviral Therapy (ART) has converted HIV/AIDS into a controllable chronic ailment. Prevalence among adults aged 15–69 years, Akwa Ibom State ranked among the highest HIV at 5.5%. Consequently, of this 5.5% (178,051 people), only 23% were on ART according to the United States Agency for International Development (USAID) in April 2019. On that note, this study becomes imperative to understand precisely the effect of the epidemic dynamics and the different treatments, and how such treatments may help Akwa Ibom State to find effective ways of reducing HIV prevalence in the state. This study sought to model the progression of the survival data from Akwa Ibom State for patients who are on ART using the Markov Decision Process and some Survival time’s probability distributions to understand the survival rates of HIV-positive patients on treatment follow-up. Finally, the study compares the different methods used in monitoring the progression and survival rate of patients on treatment follow-up. The result from the Semi-Markov Chain shows that an average of 88% of HIV/AIDS infected persons rejuvenated from the weaker states of immunity to stronger states after several transitions and maintained a steady state probability after 240 months. Again, the application of survival analysis to study the trend of survival rates with right and left censored data has been very insightful. The Kaplan Meier method shows a higher percentage of incremental stepwise probability of survival with increasing time of ART intake. In addition, the Cox regression analysis simultaneously appraise the association between multiple covariates and survival outcome of patients. In the overall evaluation, the result reveals that all the parameters considered in this study are significant and contribute immensely to the survival of patients.
Keywords: antiretroviral therapy (ART), disease progression, HIV/AIDS, semi-markov chain, survival analysis
©2025 Joshua, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.
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