Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY, USA.
Department of Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
BMC Public Health. 2020 Oct 21;20(1):1526. doi: 10.1186/s12889-020-09589-2.
Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking "friendship," so this study asked people diagnosed with syphilis and gonorrhea to identify their friends.
Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n = 331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis.
Eliciting respondents' in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio = 2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR = 1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR = 1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR = 0.98, 95% CI (0.62, 1.53)).
Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
梅毒和淋病在 2018 年达到历史最高水平。梅毒和淋病的死灰复燃需要创新的性接触追踪方法，鼓励披露可能被压制的同性性接触。超过 75%的 Grindr 手机应用用户报告寻求“友谊”，因此本研究要求诊断出梅毒和淋病的人识别他们的朋友。
巴尔的摩两家性传播感染 (STI) 诊所和巴尔的摩市卫生局的患者被要求回答 12 个问题，以引出他们友谊网络中的成员，然后再引出性网络。该研究包括 353 名索引病例和 172 名友谊接触者，产生了 331 名非分离者（n=331）的友谊网络和 140 名非分离者的性网络。使用指数家族随机图分析对数据进行绘制和分析。
除了仅通过性接触发现的 16 例梅毒病例和 4 例淋病病例外，通过引出受访者的面对面社交接触，还发现了 12 例梅毒病例和 6 例淋病病例。梅毒在性接触（比值比=2.2，95%置信区间（1.36，3.66））和社交接触（OR=1.31，95%CI（1.02，1.68））内呈聚集性。淋病在报告的社交接触（OR=1.56，95%CI（1.22，2.00））中呈聚集性，但不在性接触（OR=0.98，95%CI（0.62，1.53））中呈聚集性。
对诊断出梅毒和淋病的人的友谊网络进行调查，可能会发现他们的性网络、吸毒网络或具有相似性传播感染风险的人。友谊网络包括比性网络单独发现的梅毒和淋病病例更多，尤其是在有许多不透露性取向的男男性接触者（MSM）和女女性接触者（WSW）的人群中。未来的研究应评估如果这些 COVID-19 接触追踪方法能够保持匿名性和公众信任，这种友谊网络接触追踪方法是否可以通过改编自动化手机 COVID-19 接触追踪协议来实施。
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