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Changes in Sex Networks and Repeat STDs among Male Adolescents and Young Adults

Changes in Sex Networks and Repeat STDs among Male Adolescents and Young Adults. Jonathan M Ellen 1 , Charlotte Gaydos 1 , Michelle Chung 1 , Nancy Willard 1 , Cornelius A Rietmeijer 2 1 Johns Hopkins School of Medicine 2 Denver Public Health Department. Background.

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Changes in Sex Networks and Repeat STDs among Male Adolescents and Young Adults

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  1. Changes in Sex Networks and Repeat STDs among Male Adolescentsand Young Adults Jonathan M Ellen1, Charlotte Gaydos1, Michelle Chung1, Nancy Willard1, Cornelius A Rietmeijer2 1Johns Hopkins School of Medicine 2Denver Public Health Department

  2. Background • Individuals with repeat infection are believed to play a greater role in maintaining endemic rates STIs • Identification of individuals at increased risk for repeat infection could trigger specific interventions • Studies have failed to identify predictors of repeat GC and CT beyond race/ethnicity, age, and geography

  3. Initial vs. Repeat Infection • Correlates of initial GC/CT • Condom use • Rate of sex partner turnover • Sex partners’ networks (local networks) • Correlates of repeat GC/CT • Changes in correlates of initial STI after initial STI • Little evidence that there are changes condom use • If current sex partners treated, having a new partner may be protective or risky depending on their network

  4. Sex Networks • Prevalence of STI in local sex networks correlated with risk of STI of members • Local sex networks vary in their prevalence of STI • Individuals may migrate in and out of sex networks • Sex networks are closely linked to social networks • Could target social networks along with sex networks for control activties

  5. Objectives • To determine whether decrease in the percentage of sex partners who are within the index’s social network is associated with decrease risk for repeat GC and/or CT among those with new partners.

  6. Methods • Longitudinal research study • Asymptomatic CT- and GC-infected boys 13-25 years old from the non-detention venues in Baltimore City and Denver, CO • Participants interviewed and sex contacts notified • Re-interviewed and tested for GC/CT at 1 month and 4 months

  7. Participant Interview • Asked about each partner including • New partners since last interview • Old partners mentioned at other interviews • Queried about their perceptions of their partners drug and sex behaviors and their link to social networks • Egocentric data

  8. Number of Interval Sex Partners in Social Network Number of Total Interval Sex Partners X 100 Social and Sex Network Overlap • Each sex partner was coded as within participants’ social network or not within social network • Defined as within network if any: • Met through close friends • More than ½ of friends knew • Friends had sex with partner • Partner knew any of other sex partners • Percentage of sex partners within social network

  9. Analysis • Independent variables • New partner since last interview • Change in percentage overlap since last interview • Between baseline and 1 month interview • Between 1 month and 4 month interview • Dependent variable • GC/CT diagnosis at end of interval • Logistic regression and GEE • Analysis stratified by city

  10. Participants

  11. Recruitment Venues

  12. Overall:STD by New Partner (N=209 visits)

  13. Baltimore:STD by New Partner (71 visits)

  14. Denver:STD by New Partner (138 visits)

  15. Baltimore:STD by Change in Overlap (30 visits)* * Among those with a new partner

  16. Denver:STD by Change in Overlap (38 visits)* * Among those with a new partner

  17. Limitations • Lack of validated definition of social and sex network overlap • Relies on perceptions of partners behaviors • Small sample size

  18. Conclusion • Failure to replicate Baltimore findings in Denver may be due to differences in populations, extent of DIS activity, or limitations of study • To the extent that future studied replicate Baltimore findings, preventive treatment of social networks may reduce repeat infection among adolescents and young adults

  19. Funding • Centers for Disease Control and Prevention, Division of STD Prevention

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