The Atlanta Urban Adolescent Network Study: A Network View of STD Prevalence

In Brief Objectives: To examine the epidemiology of multiple infections in teenagers and their contacts. Goal: To demonstrate a network approach to the prevalence of STDs/HIV. Study Design: A community-based network study of ethnographically representative adolescents. Results: Of the 512 interviewees, 90% of the boys and 80% of the girls were sexually active with many partners and exhibited age-assortative mixing. Prevalences of gonorrhea, chlamydia, and HSV-2 were high, but syphilis, Hepatitis C and HIV were virtually absent. The prevalence faced by subgroups differed from overall prevalence. Conclusions: The presence of bacterial STDs and the absence of HIV, HCV, and syphilis may be the result of no IDU and assortative age mixing. Testing for multiple conditions, network assessment of prevalence, and inclusion of social contacts enhance understanding of STD epidemiology. Average prevalence for a group may be misleading, since persons face disease prevalence within their own network. Such prevalence may differ from the average based on the disease and the characteristics of individuals.