Skip Navigation LinksHome > July 2009 - Volume 4 - Issue 4 > HIV transmission networks
Current Opinion in HIV & AIDS:
doi: 10.1097/COH.0b013e32832c7cfc
Epidemiology: Edited by Tim Mastro and Quarraisha Abdool-Karim

HIV transmission networks

Rothenberg, Richard

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Purpose of review: Over the past several years, one segment of the complex field of HIV transmission dynamics – heterosexual networks – has dominated theoretical and empirical investigation. This review provides an overview of recent work on HIV risks and networks, with a focus on recent findings in heterosexual network dynamics.

Recent findings: Qualitative (ethnographic) assessments have demonstrated the heterogeneity and complexity of heterosexual connections, particularly in Africa, where tradition, official polygamy, and unofficial multiperson arrangements have lead to concurrency of sexual partnerships. A large, quantitative study on Likoma Island, Malawi, demonstrated the considerable, interlocking sexual connections that arise from a high-concurrency sexual setting, even with a low average number of partnerships (low degree) of long duration. Such settings, as suggested by ethnographic studies, may be common in Africa and, coupled with newer information about transmissibility during acute and early infection, may provide a plausible explanation for endemic transmission and possibly for rapid HIV propagation.

Summary: Recognition of high-concurrency, low-degree networks is an important development for understanding HIV transmission dynamics. Their relevance to heterosexual transmission, and possible extension to other epidemiologic settings, reinforces the heterogeneity and complexity of HIV transmission dynamics.

© 2009 Lippincott Williams & Wilkins, Inc.


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