Wallace R
Epidemiology of Mental Disorders Research Department, New York State Psychiatric Institute, NY 10032.
Soc Sci Med. 1991;32(7):847-52. doi: 10.1016/0277-9536(91)90311-y.
Observation of an essentially linear growth in time of U.S. and New York City AIDS cases, from about 1984 through early 1988, is shown to imply a relatively constant rate of transmission of HIV infection in its early stages, as has been observed for limited times in cohorts of male homosexuals in San Francisco and New York City. Observation by Potterat et al. of an exceptionally close intertwining of spatial and social patterns of endemic gonorrhea within a minority population, coupled with a percolation process model of HIV transmission within geographically constrained social networks, leads to inference that a constant rate of HIV transmission, in turn, implies a 'surface growth' phenomenon resulting in a traveling wave of infection advancing at a fixed 'velocity' along a 'one dimensional socio-geographic network.' Implications of this view are discussed for both data collection and analysis, and for intervention. Differences for the processes of disease transmission and control, based on the relative stability of socio-geographic networks, are postulated between the ghettoes of the middle-class male homosexual community and the physically devastated and socially distintegrated ghettoes of the minority urban poor.
从大约1984年到1988年初,美国和纽约市艾滋病病例数量随时间呈现出基本呈线性增长,这表明在艾滋病早期阶段,HIV感染的传播速率相对恒定,这与在旧金山和纽约市男性同性恋群体中短期内观察到的情况一致。Potterat等人观察到,在少数族裔人群中,地方性淋病的空间和社会模式异常紧密地交织在一起,再结合HIV在地理受限的社会网络中传播的渗流过程模型,由此推断,HIV传播速率恒定反过来意味着一种“表面增长”现象,即感染的传播波以固定的“速度”沿着“一维社会地理网络”推进。本文讨论了这种观点对数据收集与分析以及干预措施的影响。基于社会地理网络的相对稳定性,推测在中产阶级男性同性恋社区的聚居区与少数族裔城市贫困人口聚居区在身体遭受破坏且社会瓦解的聚居区之间,疾病传播和控制过程存在差异。