PERSONAL RISK-TAKING AND THE SPREAD OF DISEASE - BEYOND CORE GROUPS

Disease control efforts directed at human immunodeficiency virus are p redicated on the need to reduce personal risk behaviors; that approach may not adequately reflect the complicated interplay between personal behaviors and the social setting in which they occur. Efforts to date , including the application of population ecology, the development of the core group hypothesis, and the use of compartment models to descri be disease transmission, have aided in understanding the dynamics of t ransmission and have highlighted the relationship between personal ris k taking and population risk. An area for further development is the a pplication of the techniques of social network analysis to infectious disease spread. Initial work suggests that social structure may act as a barrier (or facilitator) in disease transmission and that the epide miologic impact of a risky act varies with the social setting. The loc al context for risk behaviors has important implications for the dynam ics of transmission.