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Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis
Janet E. Rosenbaum
SUNY Downstate Health Sciences University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9796-513X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends.
Methods: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis.
Results: Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)).
Conclusions: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
Keywords
gonorrhea, syphilis, partner notification, contact tracing, bisexuality, sexual orientation, labeling, self concept
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Supplementary Material 1: Stata and R code used for analysis
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This preprint is under consideration at BMC Public Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis
Janet E. Rosenbaum
SUNY Downstate Health Sciences University
Corresponding Author
ORCiD: https://orcid.org/0000-0001-9796-513X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 4
Posted 23 Sep, 2020
No comments provided
Submission checks complete
On 16 Sep, 2020
Editorial decision: Minor revision
On 15 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 04 Sep, 2020
Review #3 received
Received 02 Aug, 2020
Review #2 received
Received 02 Aug, 2020
Reviewers invited
Invitations sent on 30 Jul, 2020
Reviewer #1 agreed
On 30 Jul, 2020
Reviewer #2 agreed
On 30 Jul, 2020
Reviewer #3 agreed
On 30 Jul, 2020
Review #1 received
Received 30 Jul, 2020
Editor assigned
On 28 Jul, 2020
Submission checks complete
On 27 Jul, 2020
Editor invited
On 27 Jul, 2020
No comments provided
Editorial decision: Major revision
On 22 Jul, 2020
Review #3 received
Received 13 Jul, 2020
Review #2 received
Received 28 Jun, 2020
Reviewer #3 agreed
On 09 Jun, 2020
Review #1 received
Received 08 Jun, 2020
Reviewer #2 agreed
On 06 Jun, 2020
Reviewer #1 agreed
On 05 Jun, 2020
Reviewers invited
Invitations sent on 07 May, 2020
Editor assigned
On 14 Apr, 2020
Submission checks complete
On 13 Apr, 2020
Editor invited
On 13 Apr, 2020
First submitted
On 09 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Public Health.
Background: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends.
Methods: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis.
Results: Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)).
Conclusions: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.
Figure 1
Figure 2