THE DYNAMIC TOPOLOGY OF SEXUALLY-TRANSMITTED DISEASE EPIDEMICS - IMPLICATIONS FOR PREVENTION STRATEGIES

Each sexually transmitted disease (STD) epidemic evolves through predi ctable phases, shaped by a dynamic interplay among the pathogen, the b ehaviors of the subpopulations in which it emerges, and the prevention efforts that are developed to limit its impact. As STD epidemics move through these phases, the sexual and social networks that fuel them b ecome located in subpopulations characterized by progressively higher rates of sex partner change and less contact with the health care syst em. As a result, phase-appropriate prevention strategies and research issues are essential to reducing STDs and their consequences.