Social network methods have improved our understanding of sexually transmitted disease transmission dynamics, and may be of use in routine field operations for partner notification.
To augment traditional syphilis-control activities with social network methods in an Atlanta area with high syphilis morbidity.
Disease investigators conducted interviews, used network diagrams to prioritize their work, and relied on network connections for finding hard-to-reach persons.
A total of 396 contacts were elicited from 48 infected and 50 uninfected persons. The cumulative prevalence of syphilis was 12.6%, and 24 persons infected with HIV were identified. Network methods disclosed a large, interconnected group (276 persons) characterized by high network centrality and the substantial presence of small, interactive subgroups (microstructures).
The network approach is a feasible field technique, and can identify core groups involved in the intense transmission of syphilis. The targeted, network-based approach may be useful in attempts to eliminate syphilis.
*From the Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia; the †Fulton County Department of Health and Wellness, Atlanta, Georgia; the ‡Centers for Disease Control and Prevention, Atlanta, Georgia; and the §Georgia Department of Human Resources, Division of Public Health, Atlanta, Georgia
The authors thank Mr. Willie Beard for his invaluable contributions to street-based ethnography and follow-up, and would like to acknowledge the collaboration and assistance of the entire STD-control program at Fulton County.
Reprint requests: Richard B. Rothenberg, MD, Department of Family and Preventive Medicine, Emory University School of Medicine, 69 Butler Street SE, Atlanta, GA 30333. E-mail: firstname.lastname@example.org.
Received for publication April 19, 1999, revised June 15, 1999, and accepted June 25, 1999.