Sexual mixing patterns in the spread of gonococcal and chlamydial infections.
OBJECTIVE
This study sought to define, among sexually transmitted disease (STD) clinic attendees, (1) patterns of sex partner selection, (2) relative risks for gonococcal or chlamydial infection associated with each mixing pattern, and (3) selected links and potential and actual bridge populations.


METHODS
Mixing matrices were computed based on characteristics of the study participants and their partners. Risk of infection was determined in study participants with various types of partners, and odds ratios were used to estimate relative risk of infection for discordant vs concordant partnerships.


RESULTS
Partnerships discordant in terms of race/ethnicity, age, education, and number of partners were associated with significant risk for gonorrhea and chlamydial infection. In low-prevalence subpopulations, within-subpopulation mixing was associated with chlamydial infection, and direct links with high-prevalence subpopulations were associated with gonorrhea.


CONCLUSIONS
Mixing patterns influence the risk of specific infections, and they should be included in risk assessments for individuals and in the design of screening, health education, and partner notification strategies for populations.
Aral
S O
SO
Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
Hughes
J P
JP
Stoner
B
B
Whittington
W
W
Handsfield
H H
HH
Anderson
R M
RM
Holmes
K K
KK
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002690:Chlamydia Infections / Q000453:epidemiology / Q000635:transmission*; D002692:Chlamydia trachomatis; D002755:Choice Behavior; D004522:Educational Status; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology / Q000635:transmission*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups; D012307:Risk Factors; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000145:classification / Q000523:psychology*; D011795:Surveys and Questionnaires