From the Department of Epidemiology, Gillings School of Global Public Health.
Department of Mathematics, University of North Carolina at Chapel Hill, Chapel Hill.
Sex Transm Dis. 2020 Nov;47(11):726-732. doi: 10.1097/OLQ.0000000000001250.
Despite persistent HIV and syphilis epidemics among men who have sex with men (MSM), the relationship between HIV and syphilis contact networks has not been well characterized. We aimed to measure interconnectivity between HIV and syphilis contact networks among MSM and identify network communities with heightened interconnectivity of the syphilis network with the HIV network.
Using contact-tracing data, we generated independent and combined HIV and syphilis networks for all MSM diagnosed with HIV or early syphilis, respectively, in North Carolina between 2015 and 2017. We treated the independent networks as layers and identified network communities, or groups of densely connected nodes, in the 2-layer network. We assessed interconnectivity by comparing the mean node degree among syphilis network members in the syphilis network alone versus the combined HIV/syphilis network, both overall and by network community.
The syphilis network was interconnected with the HIV network, especially in network communities with younger median age, higher proportions of persons self-identifying as Black, non-Hispanic, and higher proportions of syphilis cases diagnosed at sexually transmitted disease clinics.
Interconnected contact networks underlie HIV and syphilis epidemics among MSM, particularly among young, Black MSM. Intensified transmission prevention interventions within highly interconnected network communities may be particularly beneficial.
尽管男男性行为者(MSM)中仍存在持续的艾滋病毒和梅毒流行,但艾滋病毒和梅毒接触网络之间的关系尚未得到很好的描述。我们旨在衡量 MSM 中艾滋病毒和梅毒接触网络之间的互联程度,并确定梅毒网络与艾滋病毒网络之间具有更高互联性的网络社区。
使用接触者追踪数据,我们为 2015 年至 2017 年期间在北卡罗来纳州分别诊断出艾滋病毒或早期梅毒的所有 MSM 生成了独立的艾滋病毒和梅毒网络。我们将独立网络视为层,并在 2 层网络中确定网络社区,即密集连接节点的组。我们通过比较梅毒网络成员在仅梅毒网络与艾滋病毒/梅毒联合网络中的平均节点度,整体上和按网络社区来评估互联性。
梅毒网络与艾滋病毒网络相互连接,尤其是在网络社区中,网络社区的中位年龄较小,自我认同为黑人、非西班牙裔的比例较高,以及在性传播疾病诊所诊断出的梅毒病例比例较高。
男男性行为者中艾滋病毒和梅毒流行的基础是相互关联的接触网络,特别是在年轻的黑人男男性行为者中。在高度互联的网络社区中加强传播预防干预措施可能特别有益。