Sexual network structure and the spread of HIV in Africa: evidence from Likoma Island, Malawi
Sexual network structure and the spread of HIV in Africa: evidence from Likoma Island, Malawi
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DOI：
10.1097/qad.0b013e328285df98
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发表时间：
2007-11-12
期刊：
影响因子：
3.8
通讯作者：
Kohler, Hans-Peter
中科院分区：
文献类型：
--
作者：
Helleringer, Stephane;Kohler, Hans-Peter
背景资料：虽然撒哈拉以南非洲低风险个人之间的性关系占艾滋病毒感染的大多数，但人们对撒哈拉以南非洲一般人口中性网络的结构和特点了解有限。调查连接马拉维利科马岛几个村庄的年轻人的性网络的人口结构，并分析HIV阳性个体在性网络中的结构位置。设计和方法：一项关于性伙伴关系和流行HIV感染生物标志物的横断面社会中心调查。结果：该研究证明，存在着一个庞大而强大的性网络，将岛上相当一部分年轻的成年人联系在一起：在所有性活跃的受访者中，有一半的人通过一个巨大的网络组件连接，超过四分之一的人通过多个独立的性关系链连接。这种高网络连通性在短时间内出现。艾滋病毒的流行率在整个网络中也有很大差异，人口稀少的区域艾滋病毒流行率高于人口密集的区域。几个风险因素有关的性混合模式有助于解释差异在艾滋病毒感染率跨网络locations.Conclusion：相反，声称在撒哈拉以南非洲农村的性网络太稀疏，以维持普遍的艾滋病毒流行病，在利科马观察到的网络结构似乎兼容的广泛传播的艾滋病毒之间的低风险群体。网络内艾滋病毒感染的非均匀分布表明，网络特征是艾滋病毒在人群中传播动态的重要决定因素。(c)2007年威科健康。
Background: Whereas sexual relationships among low-risk individuals account for the majority of HIV infections in sub-Saharan Africa, limited knowledge exists about the structure and characteristics of sexual networks among the general population in sub-Saharan Africa.Objectives: To investigate the population-level structure of sexual networks connecting the young adult population of several villages on Likoma Island (Malawi), and analyse the structural position of HIV-positive individuals within the sexual network.Design and methods: A cross-sectional sociocentric survey of sexual partnerships and biomarkers of prevalent HIV infections.Results: The study documents the existence of a large and robust sexual network linking a substantial fraction of the island's young adult population: half of all sexually active respondents were connected in a giant network component, and more than a quarter were linked through multiple independent chains of sexual relationships. This high network connectivity emerges within short time frames. The prevalence of HIV also varied significantly across the network, with sparser regions having a higher HIV prevalence than densely connected components. Several risk factors related to sexual mixing patterns help explain differentials in HIV prevalence across network locations.Conclusion: Contrary to claims that sexual networks in rural sub-Saharan Africa are too sparse to sustain generalized HIV epidemics, the structure of the networks observed in Likoma appears compatible with a broad diffusion of HIV among lower-risk groups. The non-homogeneous distribution of HIV infection within the network suggests that network characteristics are an important determinant of the dynamics of HIV spread within a population. (c) 2007 Wolters Kluwer Health.