POPULATION-BASED AND INDIVIDUAL-BASED APPROACHES TO THE DESIGN AND ANALYSIS OF EPIDEMIOLOGIC STUDIES OF SEXUALLY-TRANSMITTED DISEASE TRANSMISSION

Epidemiologic studies of sexually transmitted disease (STD) transmissi on present a number of unique challenges in design and analysis. These arise both from the social nature of STD transmission and from inhere nt difficulties in collecting accurate and informative data on exposur e and infection. Risk of acquiring an STD depends on both individual-l evel factors and the behavior and infectiousness of others. Consequent ly, study designs and analysis methods developed for studying chronic disease risk in individuals or groups may not apply directly. Simple m odels of STD transmission were used to investigate these issues, focus ing on how the interplay between individual- and population-level fact ors influences design and interpretation of epidemiologic studies, wit h particular attention to interpretation of common measures of associa tion and to common sources of bias in epidemiologic data. Existing met hods for investigating risk factors can be modified such that these is sues may be addressed directly.