Geography, networks, and risk in disease transmission

地理、网络和疾病传播风险

• 批准号: 7005274
• 负责人: RICHARD B ROTHENBERG
• 金额: $ 64.68万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-01 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7005274
• 关键词: HIV infections; Trichomonas; behavioral /social science research tag; bisexual; chlamydial disease; clinical research; communicable disease transmission; data collection methodology /evaluation; disease /disorder proneness /risk; drug abuse; gonorrhea; hepatitis C virus; herpes simplex virus 2; high risk behavior /lifestyle; homosexuals; human subject; interview; longitudinal human study; needle sharing; questionnaires; sex behavior; sexual orientation; sexually transmitted diseases; social psychology; socioenvironment; syphilis; urban area

DESCRIPTION (provided by applicant): A current network theory proposes that local (personal) choices generate global network structure and risk configuration. We base this proposal on the conceptual framework that, in inner city environments, these local choices result in multiple channels of exposure from multiple sources (compound risk); a network structure that facilitates transmission; and geographic proximity that promotes contact with those in the same network. It is the interaction of these three factors that maintains endemicity of HIV and STIs in such settings. Our specific aims are (1) To delineate the behavioral, network, and geographic characteristics of persons who are at risk because of their drug-using and sexual activity in high- and low-burden HIV areas.; (2) To assess the combined influence of these behavioral, network, and geographic factors and their dynamics on the prevalence and incidence of seven sexually transmitted and blood-borne infections (HIV, HCV, HSV-2, Syphilis, Gonorrhea, Chlamydial infection, and Trichomoniasis) in the areas with high and low burden of HIV. Our hypotheses include an expectation of a strong association between social distance (as measured by the geodesic, or shortest distance between two persons in a connected group) and geographic distance (as measured by the metric distance between those two persons); demonstration of the presence and importance of compound risk; confirmation that small networks have structural features that facilitate transmission, and quantitative confirmation of the greater importance of these characteristics in high-burden HIV areas compared to low-burden HIV areas. We will use ethnographic methods to identify 3 "seeds" in each of 5 high-burden and 5 low-burden zip codes, and will use a chain-link design to construct 30 networks of approximately 25 persons each who will be interviewed and tested at baseline and in three follow-up contacts 9 months apart. Their first-degree contacts will be sought, interviewed and tested, to produce a sample of 750 persons at each interview wave. We will use epidemiologic, network, and geospatial analytic methods to examine our underlying hypotheses. If the hypotheses are substantiated, the findings will suggest that categorical approaches to risk reduction in the endemic disease environment are unlikely to be successful; that geographic relationships are factors of basic importance in understanding disease transmission; that geographic proximity supports the need for focused, targeted intervention; and that future modeling efforts relating network structure and dynamics to disease transmission will be enhanced.

描述（由申请人提供）： 当前的网络理论提出，局部（个人）选择会产生全局网络结构和风险配置。我们的建议基于以下概念框架：在内城环境中，这些本地选择会导致多种来源的多种暴露渠道（复合风险）；便于传输的网络结构；地理上的接近促进了与同一网络中的人的联系。正是这三个因素的相互作用维持了艾滋病毒和性传播感染在这些地区的流行。我们的具体目标是 (1) 描绘高、低艾滋病毒感染地区因吸毒和性活动而面临风险的人的行为、网络和地理特征。 (2) 评估这些行为、网络和地理因素及其动态对艾滋病高负担和低负担地区七种性传播和血源性感染（HIV、HCV、HSV-2、梅毒、淋病、衣原体感染和滴虫病）患病率和发病率的综合影响。我们的假设包括预期社交距离（通过测地线测量，或相连群体中两个人之间的最短距离）和地理距离（通过这两个人之间的公制距离测量）之间存在很强的关联；证明复合风险的存在和重要性；确认小型网络具有促进传播的结构特征，并定量确认这些特征在艾滋病毒高负担地区比艾滋病毒低负担地区更重要。我们将使用人种学方法在 5 个高负担和 5 个低负担邮政编码中分别识别 3 个“种子”，并将使用链式设计构建 30 个网络，每个网络约 25 人，这些网络将在基线和相隔 9 个月的 3 个后续接触中接受采访和测试。我们将寻找、采访和测试他们的一级联系人，以便在每次采访中产生 750 人的样本。我们将使用流行病学、网络和地理空间分析方法来检验我们的基本假设。如果这些假设得到证实，研究结果将表明，在地方病环境中降低风险的分类方法不太可能成功；地理关系是了解疾病传播的基本重要因素；地理邻近性支持有重点、有针对性的干预的必要性；未来将加强将网络结构和动态与疾病传播相关的建模工作。