From individuals to complex systems: exploring the sexual networks of men who have sex with men in three cities of Karnataka, India
From individuals to complex systems: exploring the sexual networks of men who have sex with men in three cities of Karnataka, India
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DOI：
10.1136/sti.2010.044909
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发表时间：
2010-12-01
影响因子：
3.6
通讯作者：
Blanchard, James F.
中科院分区：
文献类型：
--
作者：
Lorway, Robert;Shaw, Souradet Y.;Blanchard, James F.
在印度，对男男性行为者（MSM）艾滋病毒易感性的研究往往侧重于个人风险行为的总和。然而，这种方法往往忽略了性网络的复杂性，而性网络最终是传播模式的基础。本文分析了一组性接触网络（SCN）快照与人种学研究结果的关系，以从更复杂的系统角度重新定位风险行为的个人层面解释。方法15名社区研究人员在卡纳塔克邦3个城市进行了为期2个月的民族志研究，对男男性行为者居住的危险环境进行了描述。用两种方法重建了scn。首先，最初的参与者，被定义为各种性网络的节点，被有目的地抽样。在每个站点中，六个节点分别带来三个性伴侣作为参与者。在所有网站中，72名参与者完成了431份关于他们7天性伴侣的调查。其次，每个站点确定了代表不同性网络的四个组，每个组包含四个个体。在所有网站中，48名参与者完成了334份针对其固定性伴侣的调查。结果在几乎所有包括行为变量的地点之间观察到相当大的差异。就其本身而言，这些特征在理解每个地点的艾滋病毒流行差异方面产生了相互矛盾的解释。然而，将这些变量与scn和人种学数据联系起来，产生了对艾滋病毒易感性的非线性解释，这表明了当地干预措施的重要性。结论：SCN数据可以与现有的风险行为和脆弱性结构决定因素数据一起使用，以重新制定更有针对性的干预措施。
Introduction Research on the HIV vulnerability of men who have sex with men (MSM) in India has tended to focus on aggregates of individual risk behaviours. However, such an approach often overlooks the complexities in the sexual networks that ultimately underpin patterns of spread. This paper analyses a set of sexual contact network (SCN) snapshots in relation to ethnographic findings to reorientate individual-level explanations of risk behaviour in terms of more complex systems.Methods Fifteen community researchers conducted a 2-month ethnographic study in three cities in Karnataka to generate descriptions of the risk environments inhabited by MSM. SCNs were reconstructed by two methods. First, initial participants, defined as nodes of various sexual networks, were purposively sampled. In each site, six nodes brought in three sexual partners separately as participants. In all sites, 72 participants completed 431 surveys for their 7-day sexual partners. Second, each site determined four groups representing various sexual networks, each group containing four individuals. In all sites, 48 participants completed 334 surveys for their regular sexual partner.Results Considerable differences were observed between sites for practically all included behavioural variables. On their own, these characteristics yielded contradictory interpretations with respect to understanding contrasts in HIV prevalence at each site. However, viewing these variables in relation to SCNs and ethnographic data produced non-linear interpretations of HIV vulnerability which suggested importance to local interventions.Conclusion SCN data may be used with existing data on risk behaviour and the structural determinants of vulnerability to re-tailor more tightly focused interventions.