title: Spatial bridges for the importation of gonorrhea and chlamydial infection.
abstract: A study of heterosexuals with gonorrhea and/or chlamydial infection in King County, Washington, found that 5.2% of study participants had both local and geographically distant sex partners in the 60 days before diagnosis. Individuals who served as spatial bridges were of higher socioeconomic status and older than other patients.
  
  
  BACKGROUND
  Sexual mixing between distant geographic areas (spatial bridging) is important in the spread of antimicrobial resistance and new sexually transmitted disease pathogens.
  
  
  OBJECTIVE
  The goal was to define the extent of sexual mixing between persons with gonorrhea or chlamydial infection in King County, Washington, and persons outside the Seattle area, and to identify characteristics of persons and partnerships associated with spatial bridging.
  
  
  METHODS
  Patients contacted for purposes of partner notification were interviewed regarding demographics, sexual behavior, and the characteristics of their sex partners.
  
  
  RESULTS
  Of 2912 participants, 150 (5.2%) were spatial bridgers. Bridgers were of higher socioeconomic status than nonbridgers and more often reported concurrent partnerships. Over a 39-month period, bridgers and potential bridgers linked King County with 35 states and 13 foreign countries.
  
  
  CONCLUSIONS
  Spatial bridging could represent an important channel of transmission between geographic areas. These results highlight the need for linkage of prevention efforts across geographic boundaries.
authors.affiliation: Center for AIDS and STD, Harborview Medical Center, University of Washington, Seattle, Washington 98104, USA. rkerani@u.washington.edu
authors.forename: Roxanne P
authors.initials: RP
authors.lastname: Kerani
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Golden
authors.forename: William L H
authors.initials: WL
authors.lastname: Whittington
authors.forename: H Hunter
authors.initials: HH
authors.lastname: Handsfield
authors.forename: Matthew
authors.initials: M
authors.lastname: Hogben
authors.forename: King K
authors.initials: KK
authors.lastname: Holmes
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission*; D016358:Contact Tracing; D003710:Demography; D018562:Disease Transmission, Infectious; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology* / Q000209:etiology / Q000635:transmission*; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012725:Sexual Behavior; D012747:Sexual Partners; D012923:Social Class; D014861:Washington / Q000453:epidemiology