Sexual Networks and Gonorrhoea
The social factors shaping the spread of sexually transmitted infections (STIs) include:
the extent to which sexual networks are based on assortative or disassortative sexual mixing
the role of serial monogamy and partner concurrency
whether people move between monogamy and concurrency.
There is increasing acknowledgement that STIs have a marked spatial distribution, prompting questions about the characteristics of the social spaces in which sexual partners meet and live, and whether they have distinct sexual cultures.
In collaboration with Graham Hart (SPHSU and now University College London), the spatial patterning of recent gonorrhoea cases in Glasgow has been analysed at three levels to investigate how the resurgence of this infection relates to individual attributes and behaviours, social factors (particularly deprivation) and the adequacy of health service provision.
The first level analysed NHS laboratory data; this suggested that the association between deprivation and gonorrhoea was highly dependent on gender. At the second level, a nested case control study found that homo-bisexual orientation and same gender sexual partnerships are the strongest predictors of gonorrhoea acquisition. Deprivation was not associated with gonococcal infection, after controlling for the effects of other risk factors. At the third level, qualitative interviews with 20 people recently diagnosed with gonorrhoea, previously conducted by Judith Connel (SPHSU and now University of Glasgow), have been analysed by Stephanie Church (SPHSU and now University of Strathclyde) to examine whether social and sexual networks can help explain the recent resurgence of gonorrhoea.
Abu-Rajab K, Palmer HM, Scoular A, Church S, Connell J, Hart G, Winter AJ. To what extent does Neisseria gonorrhoeae multiantigen sequence typing of gonococcal isolates support information derived from patient interviews?. International Journal of STD & AIDS 2009;20:414-7pubmed
Abu-Rajab K, Scoular A, Church S, Connell J, Winter AJ, Hart G. Identifying opportunities for sexually transmitted infection prevention: analysis of critical points in the care pathways of patients with gonorrhoea. International Journal of STD & AIDS 2009;20:170-5pubmed