MAPPING A SOCIAL NETWORK OF HETEROSEXUALS AT HIGH-RISK FOR HIV-INFECTION

Objective: To determine how heterosexuals at risk for HIV infection in terconnect in social networks and how such relationships affect HIV tr ansmission. Design: Cross-sectional study with face-to-face interviews to ascertain sociosexual connections; serologic testing. Participants : Prostitute women (n = 133), their paying (n = 129) and non-paying (n = 47) male partners; injecting drug users (n = 200) and their sex par tners (n = 41). Participants were recruited in sexually transmitted di sease and methadone clinics, an HIV-testing site, and through street o utreach in Colorado Springs, Colorado, USA. Main outcome measures: Rep orted behaviors, risk perceptions, sociosexual linkages, and HIV preva lence. Results: Respondents were well informed, but reported engaging in high-risk behaviors frequently. Nevertheless, over 70% of responden ts perceived themselves to be at row risk for HIV infection. The 595 r espondents identified a social network of 5162 people to which they be longed. Network analytic methods indicated 147 separate connected comp onents of this network; eight of the 19 HIV-positive individuals in th e network were located in smaller components remote from the largest c onnected component. Conclusion: The isolated position of HIV-positive individuals may serve as a barrier to HIV transmission and may account for the lack of diffusion of HIV in heterosexual populations in this region. Network analysis appears useful for understanding the dynamics of disease transmission and warrants further development as a tool fo r intervention and control.