Mapping a social network of heterosexuals at high risk for HIV infection.
OBJECTIVE
To determine how heterosexuals at risk for HIV infection interconnect in social networks and how such relationships affect HIV transmission.


METHODS
Cross-sectional study with face-to-face interviews to ascertain sociosexual connections; serologic testing.


METHODS
Prostitute women (n = 133), their paying (n = 129) and non-paying (n = 47) male partners; injecting drug users (n = 200) and their sex partners (n = 41). Participants were recruited in sexually transmitted disease and methadone clinics, an HIV-testing site, and through street outreach in Colorado Springs, Colorado, USA.


METHODS
Reported behaviors, risk perceptions, sociosexual linkages, and HIV prevalence.


RESULTS
Respondents were well informed, but reported engaging in high-risk behaviors frequently. Nevertheless, over 70% of respondents perceived themselves to be at low risk for HIV infection. The 595 respondents identified a social network of 5162 people to which they belonged. Network analytic methods indicated 147 separate connected components of this network; eight of the 19 HIV-positive individuals in the network were located in smaller components remote from the largest connected component.


CONCLUSIONS
The isolated position of HIV-positive individuals may serve as a barrier to HIV transmission and may account for the lack of diffusion of HIV in heterosexual populations in this region. Network analysis appears useful for understanding the dynamics of disease transmission and warrants further development as a tool for intervention and control.
Woodhouse
D E
DE
El Paso County Department of Health and Environment, Colorado Springs.
Rothenberg
R B
RB
Potterat
J J
JJ
Darrow
W W
WW
Muth
S Q
SQ
Klovdahl
A S
AS
Zimmerman
H P
HP
Rogers
H L
HL
Maldonado
T S
TS
Muth
J B
JB
D000328:Adult; D003120:Colorado; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D006801:Humans; D008297:Male; D012309:Risk-Taking; D012649:Self Concept; D011477:Sex Work / Q000523:psychology; D012725:Sexual Behavior / Q000523:psychology*; D012747:Sexual Partners; D012919:Social Behavior; D015819:Substance Abuse, Intravenous / Q000523:psychology