The Atlanta urban networks study: A blueprint for endemic transmission

Richard B. Rothenberg, David M. Long, Claire E. Sterk, Albert Pach, John J. Potterat, Stephen Muth, Julie A. Baldwin, Robert T. Trotter

Research output: Contribution to journalArticlepeer-review

63 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)2191-2200
Number of pages10
Issue number14
StatePublished - 2000


  • HIV
  • Injecting drug use
  • Sexual activity
  • Social networks
  • Transmission dynamics

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


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