CONTROL OF EPIDEMIC EARLY SYPHILIS - THE RESULTS OF AN INTERVENTION CAMPAIGN USING SOCIAL NETWORKS

Background: During an epidemic of early syphilis, social networks were used for an intervention campaign. Goal of this Study: To characteriz e the epidemic and describe the yield of new cases from index-case int erviews. Methods: Analyses of morbidity data collected by the Montgome ry County, Alabama, sexually transmitted disease program determined th e course of the epidemic and characterized the new case yields from so cial networks identified via index-case interviews (partner notificati on investigations) and interviews with sex partners and their associat es (cluster investigations). Results and costs were compared to a nonc ampaign period. Results: The number of reported syphilis cases nearly doubled from 1990 to 1991 (201 to 348 per 100,000 residents), During t he 21-week campaign, 373 case-patients had partner notification/cluste r investigations; 113 (11%) of 984 sex partners and 41 (3%) of 1,146 h igh-risk associates (persons identified during cluster investigations) had syphilis. No subgroup of case-patients for which the partner noti fication/cluster investigation yielded more infected persons than othe r subgroups was identified. The cost per case detected was more than t wice that during a noncampaign period ($1,627 vs. $771). Conclusion: P artner notification investigations yielded more infected persons than cluster investigations. Further evaluation is needed to determine the role of intense partner notification/cluster investigators' efforts in the control of epidemic syphilis.