Patterns of chlamydia and gonorrhea infection in sexual networks in Manitoba, Canada

Background The use of sexual network analysis has the potential to further our understanding of sexually tranmitted disease (STD) epidemics and contribute to the development of more effective targeted control strategies. Goal To use sexual network analysis to study transmission patterns of chlamydia and gonorrhea in Manitoba, Canada. Study Design Routinely collected case/contact information gathered by public health nurses was used to construct the sexual network. Results Components within the sexual network ranged in size from 2 to 82 people. Two types of components, designated radial and linear, were described. Large linear components resembled the theoretical structure of STD core groups. Geographic analysis of the largest components demonstrated the potential for STD transmission between isolated rural communities and within different areas of an urban center. Conclusions The application of sexual network analysis on a provincial basis demonstrated the importance of a centralized, coordinated approach to STD control. The analysis highlights the need for a greater understanding of the causative factors promoting the formation of different component types, the homogeneity and heterogeneity of behaviors within and between components, and the temporal stability of these patterns.