MATHEMATICAL-MODELING OF EPIDEMIC SYPHILIS TRANSMISSION - IMPLICATIONS FOR SYPHILIS CONTROL PROGRAMS

Background and Objectives: The past 10 gears' wave of syphilis epidemi cs has challenged syphilis control programs. Although apparently conne cted to drugs-for-sex trading of crack cocaine, the genesis and resolu tion of these epidemics is poorly understood, Goals of tire Study: The goals of this study were to develop a mathematical model of epidemic syphilis transmission based on empiric data, to stimulate and ascertai n behavioral and sociologic features necessary to produce epidemic tra nsmission, and to explore mechanisms leading to resolution of epidemic transmission, Study Design: The study used multi-compartment iterativ e computer simulation using empirically derived input data, Results: E pidemic transmission resulted from adding a small core group of indivi duals with very high levels of partner exchange (300-400 partners per year) to a population with levels of partner exchange seen in the gene ral population. Epidemic resolution could result from immunity or subt le changes in the size or partner exchange rate of the core group. Con clusions: There is a need for sexually transmitted disease control pro grams to reevaluate their approach to prevention and control of epidem ic syphilis in light of data on transmission dynamics.