Syphilis in Chicago: Epidemiology, Sexual Networking and Modeling for Prevention

项目名称：芝加哥的性行为：流行病学、性网络和建模 预防 摘要 至少10年来，梅毒的发病率在美国一直在上升，特别是 男男性行为者（MSM）梅毒血清阳性率较高， 感染艾滋病毒的男男性行为者，无安全套性接触的指标， 艾滋病毒感染事件。芝加哥是梅毒流行的主要中心之一 包括美国最大的非洲裔美国人。 我们建议确定和描述那些最有可能发生新的事件的人， 复发性梅毒感染并更好地定义传播、再感染的模式 以及不同MSM群体的社会和性网络中的共同感染（16-39 年龄）的人受到不成比例的影响。这项研究，STI芝加哥 流行病学网络研究（SCENES），将招募150名高危男男性行为者， 在芝加哥三个最高的 流行社区，并监测他们每季度为2年的事件梅毒 包括艾滋病毒在内的其他性传播感染。我们将收集详细的社会和性网络，并风险 行为数据并创建一个基于我们现有的梅毒传播模型 基于MSM代理的艾滋病传播模型平台，纳入详细的性 网络动态、梅毒治疗和再感染。我们也将与我们的 现有的芝加哥公共卫生部计划和外展诊所， 协调性传播感染的治疗，确定以前的治疗和感染史， 让客户参与护理和提供避孕套和PrEP，这是我们目前的做法。 这一建议将有助于对梅毒发病率的宝贵的新知识， 芝加哥最高流行率的社区，并提供一个清晰的了解， 梅毒单感染和合并感染网络。性网络动态分析 指数随机图模型，嵌入我们现有的基于代理的 模型平台将提供一个机会，包括未来的遗传网络数据， 作为一个框架，在开展新的预防干预措施之前， 临床试验或实施预防策略。

Project Title: Syphilis in Chicago: Epidemiology, Sexual Networking and Modeling for Prevention ABSTRACT The incidence of syphilis has been increasing in the US for at least 10 years, especially among men who have sex with men (MSM). Syphilis seroprevalence is higher among HIV-infected MSM, an indicator of condomless sexual contact and associated with incident HIV infection. Chicago is one of the major epicenters of the syphilis epidemic and includes the largest contiguous African American population in the United States. We propose to identify and characterize those at greatest risk for incident new and recurrent syphilis infections and better define the patterns of transmission, reinfection and co-infection within the social and sexual networks of a diverse group of MSM (16-39 years of age) who are disproportionately impacted. The study, STI Chicago Epidemiology Network Study (SCENES), will enroll 150 high-risk MSM using a recently developed two-step (2S) network recruitment approach in three of Chicago's highest prevalence neighborhoods and monitor them quarterly for 2 years for incident syphilis and other STIs including HIV. We will collect detailed social and sexual network, and risk behavior data and create a syphilis transmission model that is built upon our existing MSM agent-based HIV transmission model platform to incorporate detailed sexual network dynamics, syphilis treatment and reinfection. We will also work closely with our existing Chicago Department of Public Health programs and outreach clinics in order to coordinate treatment of STIs, determine previous treatment and infection histories, engage clients in care and provision of condoms and PrEP as is our current practice. This proposal will contribute valuable new knowledge about syphilis incidence in the highest prevalence neighborhoods in Chicago, and provide a clear understanding of syphilis mono- and co-infection networks. Sexual network analysis using dynamic exponential random graph models that are embedded within our existing agent-based model platform will provide an opportunity to include future genetic network data and serve as a framework for testing emerging prevention interventions prior to conducting clinical trials or implementing prevention strategies.