Sex partner concurrency, geographic context, and adolescent sexually transmitted infections

Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21224, USA.
Sex Transm Dis (Impact Factor: 2.75). 01/2005; 31(12):734-9. DOI: 10.1097/01.olq.0000145850.12858.87
Source: PubMed

ABSTRACT Geographic areas characterized by a high prevalence of sexually transmitted infections (STIs) are critical to the maintenance and persistence of STIs within populations. Sex partner concurrency has been shown to be associated with increased risk for individual-level STIs.
The objectives of this study were to determine whether gonorrhea rate per census block group and sex partner concurrency independently and interactively are associated with a current bacterial STI among adolescents.
Face-to-face interviews and urine testing for Chlamydia trachomatis and Neisseria gonorrhoeae were conducted among female, sexually active, 14- to 19-year-olds presenting for reproductive clinic care between August 2000 and June 2002.
Gonorrhea rate per census block group and sex partner concurrency were not independently but were interactively associated with a current bacterial STI. Among participants with a main sex partner who practiced concurrency, living in high-prevalence geographic areas was significantly associated with a current bacterial STI.
The results suggest that geographic context may moderate an adolescent sex partner's behaviors. The research adds to the basic understanding of sexually transmitted disease transmission and acquisition in a high-prevalence inner-city setting.

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    • "The connections between individuals (with these connections being influenced by the aforementioned variables) may be described by such general terms as 'mixing patterns' or 'contact networks' (Ward et al., 2014). Thus, in the case of sexually transmitted infections (STIs), sexual mixing patterns are significant (Adimora & Schoenbach, 2005; Aral et al., 1999; Garnett & Anderson, 1993, 1994; Gupta, Anderson, & May, 1989; Jennings, Glass, Parham, Adler, & Ellen, 2004; Kyung-Hee, Operario, Gregorich, & Lei, 2003), while, in that of pandemic influenza, child–child and child–adult mixing patterns are significant (Fedson, 2005; Ferguson, Fraser, Donnelly, Ghani, & Anderson, 2004; Pham Ngoc et al., 2006; Poland, Jacobson, & Targonski, 2007; Rahamat-Langendoen, van Vliet, & Suijkerbuijk, 2006; Schenzle, 1984; Ungchusak et al., 2005), or more broadly rates of mixing within and between age cohorts may be an important variable. It is a feature of most epidemiological systems that such patterns are notoriously difficult to measure. "
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    ABSTRACT: Incorporation of 'social' variables into epidemiological models remains a challenge. Too much detail and models cease to be useful; too little and the very notion of infection - a highly social process in human populations - may be considered with little reference to the social. The French sociologist Émile Durkheim proposed that the scientific study of society required identification and study of 'social currents'. Such 'currents' are what we might today describe as 'emergent properties', specifiable variables appertaining to individuals and groups, which represent the perspectives of social actors as they experience the environment in which they live their lives. Here we review the ways in which one particular emergent property, hope, relevant to a range of epidemiological situations, might be used in epidemiological modelling of infectious diseases in human populations. We also indicate how such an approach might be extended to include a range of other potential emergent properties to represent complex social and economic processes bearing on infectious disease transmission.
    Global Public Health 02/2015; 10(4):1-11. DOI:10.1080/17441692.2015.1007155 · 0.92 Impact Factor
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    • "This method can be burdensome and is also prone to misclassification, as well as underreporting (Manhart et al., 2002). Defining concurrent sexual behavior as having an extra sexual partner beyond a primary partner like a spouse (Jennings et al., 2004) could also result in misclassification of some who do not have sex at all with their primary partner, therefore rendering the sexual relationship with their extra partner as non-concurrent. Directly asking respondents whether they have more than one sex partners during a certain period (Daker-White and Barlow, 1997; Colvin et al., 1998) is easily implemented, however this method may have recall limitations. "
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    ABSTRACT: We sought to determine the pattern of the concurrent sexual partnerships among Chinese men and its correlates with individual, partnership and community factors. Using data from the Chinese Health and Family Life Survey, we examined the prevalence and distribution of sexual concurrency of 1689 men. A two-level logistic regression was employed to assess variables associated with sexual concurrency. Nine percent of men had concurrent sexual partnerships in preceding year. Sexual concurrency was associated with higher income (OR, 1.21; 95% CI, 1.02 to 1.48), longer traveling time (OR, 2.03; 95% CI, 1.44 to 2.87), and more frequent socializing activities (OR, 1.15; 95% CI, 1.01 to 1.30). Men who perpetrated domestic violence (OR, 1.92; 95% CI, 1.20 to 3.08) and perceived partners having other concurrent partners (OR, 4.19; 95% CI, 1.95 to 9.02) were more likely to have concurrent sexual partnerships. Tolerant community attitude towards sexual behavior and community education level showed effects on men's concurrency involvement. The results contribute to a better understanding of the potential role of concurrent sexual partnerships in the spread of HIV and other STIs in China.
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