title: The Atlanta Urban Networks Study: a blueprint for endemic transmission.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Emory University School of Medicine, Atlanta, Georgia, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Rothenberg
authors.forename: D M
authors.initials: DM
authors.lastname: Long
authors.forename: C E
authors.initials: CE
authors.lastname: Sterk
authors.forename: A
authors.initials: A
authors.lastname: Pach
authors.forename: J J
authors.initials: JJ
authors.lastname: Potterat
authors.forename: S
authors.initials: S
authors.lastname: Muth
authors.forename: J A
authors.initials: JA
authors.lastname: Baldwin
authors.forename: R T
authors.initials: RT
authors.lastname: Trotter
mesh_terms: D000328:Adult; D016578:Crack Cocaine; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D003932:Heroin; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D015995:Prevalence; D012737:Sex Factors; D012725:Sexual Behavior; D012920:Social Behavior Disorders / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014505:Urban Population
chemical_list: D016578:Crack Cocaine; D003932:Heroin