TY - JOUR
T1 - The Atlanta urban networks study
T2 - A blueprint for endemic transmission
AU - Rothenberg, Richard B.
AU - Long, David M.
AU - Sterk, Claire E.
AU - Pach, Albert
AU - Potterat, John J.
AU - Muth, Stephen
AU - Baldwin, Julie A.
AU - Trotter, Robert T.
PY - 2000
Y1 - 2000
N2 - Objective: To study prospectively social networks and behavior in a group of persons at risk for HIV because of their drug-using and sexual practices, with particular emphasis on the interaction of risks and concomitant network structure. Methods: A longitudinal study was conducted of 228 respondents in Atlanta, Georgia in six inner-city community chains of connected persons, interviewing primary respondents and a sample of their contacts every 6 months for 2 years. Ascertained were: HIV and immunologic status; demographic, medical, and behavioral factors; and the composition of the social, sexual, and drug-using networks. Results: The prevalence of HIV in this group was 13.3% and the incidence density was 1.8% per year. Substantial simultaneity of risk-taking was observed, with a high level of both non-injecting (crack, 82%) and injecting (heroin, cocaine or both, 16-30%) drug use, the exchange of sex or money for drugs by men (approximately 35%) and women (57-71%), and high frequency of same-sex sexual activity by men (9.4%) and women (33%). The intensity of interaction, as measured by network features such as microstructures and concurrency, was significantly greater than that observed in a low prevalence area with little endemic transmission. Conclusion: The traditional hierarchical classification of risk for HIV may impede our understanding of transmission dynamics, which, in the setting of an inner-city population, is characterized by simultaneity of risk-taking, and moderately intense network interactions. The study provides further evidence for the relationship of network structure to transmission dynamics, but highlights the difficulties of using network information for prediction of individual seroconversion. (C) 2000 Lippincott Williams and Wilkins.
AB - Objective: To study prospectively social networks and behavior in a group of persons at risk for HIV because of their drug-using and sexual practices, with particular emphasis on the interaction of risks and concomitant network structure. Methods: A longitudinal study was conducted of 228 respondents in Atlanta, Georgia in six inner-city community chains of connected persons, interviewing primary respondents and a sample of their contacts every 6 months for 2 years. Ascertained were: HIV and immunologic status; demographic, medical, and behavioral factors; and the composition of the social, sexual, and drug-using networks. Results: The prevalence of HIV in this group was 13.3% and the incidence density was 1.8% per year. Substantial simultaneity of risk-taking was observed, with a high level of both non-injecting (crack, 82%) and injecting (heroin, cocaine or both, 16-30%) drug use, the exchange of sex or money for drugs by men (approximately 35%) and women (57-71%), and high frequency of same-sex sexual activity by men (9.4%) and women (33%). The intensity of interaction, as measured by network features such as microstructures and concurrency, was significantly greater than that observed in a low prevalence area with little endemic transmission. Conclusion: The traditional hierarchical classification of risk for HIV may impede our understanding of transmission dynamics, which, in the setting of an inner-city population, is characterized by simultaneity of risk-taking, and moderately intense network interactions. The study provides further evidence for the relationship of network structure to transmission dynamics, but highlights the difficulties of using network information for prediction of individual seroconversion. (C) 2000 Lippincott Williams and Wilkins.
KW - HIV
KW - Injecting drug use
KW - Sexual activity
KW - Social networks
KW - Transmission dynamics
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U2 - 10.1097/00002030-200009290-00016
DO - 10.1097/00002030-200009290-00016
M3 - Article
C2 - 11061661
AN - SCOPUS:0033787966
SN - 0269-9370
VL - 14
SP - 2191
EP - 2200
JO - AIDS
JF - AIDS
IS - 14
ER -