Social network methods for endemic foci of syphilis - A pilot project

Background: Social network methods have improved our understanding of sexua lly transmitted disease transmission dynamics, and may be of use in routine field operations for partner notification. Goal: To augment traditional syphilis-control activities with social networ k methods in an Atlanta area with high syphilis morbidity, Study Design: Disease investigators conducted interviews, used network diag rams to prioritize their work, and relied on network connections for findin g hard-to-reach persons. Results: A total of 396 contacts were elicited from 48 infected and 50 unin fected persons. The cumulative prevalence of syphilis was 12.6%, and 24 per sons infected with HIV mere identified. Network methods disclosed a large, interconnected group (276 persons) characterized by high network centrality and the substantial presence of small, interactive subgroups (microstructu res). Conclusion: The network approach is a feasible field technique, and can ide ntify core groups involved in the intense transmission of syphilis. The tar geted, network-based approach may be useful in attempts to eliminate syphil is.