scholarly journals Giving syphilis and gonorrhea to friends: Using in-person friendship networks to find additional cases of gonorrhea and syphilis

2020 ◽  
Author(s):  
Janet E. Rosenbaum ◽  
Jacky Jennings ◽  
Jonathan Ellen ◽  
Laurel Borkovic ◽  
Jo-Ann Scott ◽  
...  

Abstract Background: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. Methods: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. Results: Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). Conclusions: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.

2020 ◽  
Author(s):  
Janet E. Rosenbaum ◽  
Jacky Jennings ◽  
Jonathan Ellen ◽  
Laurel Borkovic ◽  
Jo-Ann Scott ◽  
...  

Abstract Background: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends.Methods: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis.Results: Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). Conclusions: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Janet E. Rosenbaum ◽  
Jacky Jennings ◽  
Jonathan M. Ellen ◽  
Laurel M. Borkovic ◽  
Jo-Ann Scott ◽  
...  

Abstract Background Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends. Methods Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n = 331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis. Results Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio = 2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR = 1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR = 1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR = 0.98, 95% CI (0.62, 1.53)). Conclusions Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.


2020 ◽  
Author(s):  
Janet E. Rosenbaum ◽  
Jacky Jennings ◽  
Jonathan Ellen ◽  
Laurel Borkovic ◽  
Jo-Ann Scott ◽  
...  

Abstract Background: Syphilis and gonorrhea reached an all-time high in 2018. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex sexual contacts that might otherwise be suppressed. Over 75% of Grindr mobile phone application users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends.Methods: Patients at the two Baltimore sexually transmitted infection (STI) clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 friendship contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis.Results: Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). Conclusions: Eliciting friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing men who have sex with men (MSM) and women who have sex with women (WSW). Future research should evaluate whether this friendship network method of contact tracing can be implemented by adapting automated mobile phone COVID-19 contact tracing protocols, if these COVID-19 contact tracing methods are able to maintain anonymity and public trust.


2020 ◽  
Author(s):  
Janet E. Rosenbaum ◽  
Jacky Jennings ◽  
Jonathan Ellen ◽  
Laurel Borkovic ◽  
Jo-Ann Scott ◽  
...  

Abstract Background: Syphilis and gonorrhea reached an all-time high in 2018, including in populations that stigmatize same-sex sexual contact. The resurgence of syphilis and gonorrhea requires innovative methods of sexual contact tracing that encourage disclosure of same-sex contacts. Over 75% of Grindr users report seeking “friendship,” so this study asked people diagnosed with syphilis and gonorrhea to identify their friends.Methods: Patients at the two Baltimore STI clinics and the Baltimore City Health Department were asked 12 questions to elicit members of their friendship networks before eliciting sexual networks. The study included 353 index cases and 172 contacts, yielding a friendship network of 331 non-isolates (n=331) and sexual-only network of 140 non-isolates. The data were plotted and analyzed using exponential family random graph analysis.Results: Eliciting respondents’ in-person social contacts yielded 12 syphilis cases and 6 gonorrhea cases in addition to the 16 syphilis cases and 4 gonorrhea cases that would have been found with sexual contacts alone. Syphilis is clustered within sexual (odds ratio=2.2, 95% confidence interval (1.36, 3.66)) and social contacts (OR=1.31, 95% CI (1.02, 1.68)). Gonorrhea is clustered within reported social (OR=1.56, 95% CI (1.22, 2.00)) but not sexual contacts (OR=0.98, 95% CI (0.62, 1.53)). Conclusions: Eliciting the friendship networks of people diagnosed with syphilis and gonorrhea may find members of their sexual networks, drug use networks, or people of similar STI risk. Friendship networks include more diagnosed cases of syphilis and gonorrhea than sexual networks alone, especially among populations with many non-disclosing MSM and WSW.


10.28945/4736 ◽  
2021 ◽  
Vol 16 ◽  
pp. 101-124
Author(s):  
Paul Kariuki ◽  
Lizzy O Ofusori ◽  
Prabhakar Rontala Subramanniam ◽  
Moses Okpeku ◽  
Maria L Goyayi

Aim/Purpose: The paper’s objective is to examine the challenges of using the mobile phone to mine location data for effective contact tracing of symptomatic, pre-symptomatic, and asymptomatic individuals and the implications of this technology for public health governance. Background: The COVID-19 crisis has created an unprecedented need for contact tracing across South Africa, requiring thousands of people to be traced and their details captured in government health databases as part of public health efforts aimed at breaking the chains of transmission. Contact tracing for COVID-19 requires the identification of persons who may have been exposed to the virus and following them up daily for 14 days from the last point of exposure. Mining mobile phone location data can play a critical role in locating people from the time they were identified as contacts to the time they access medical assistance. In this case, it aids data flow to various databases designated for COVID-19 work. Methodology: The researchers conducted a review of the available literature on this subject drawing from academic articles published in peer-reviewed journals, research reports, and other relevant national and international government documents reporting on public health and COVID-19. Document analysis was used as the primary research method, drawing on the case studies. Contribution: Contact tracing remains a critical strategy in curbing the deadly COVID-19 pandemic in South Africa and elsewhere in the world. However, given increasing concern regarding its invasive nature and possible infringement of individual liberties, it is imperative to interrogate the challenges related to its implementation to ensure a balance with public governance. The research findings can thus be used to inform policies and practices associated with contact tracing in South Africa. Findings: The study found that contact tracing using mobile phone location data mining can be used to enforce quarantine measures such as lockdowns aimed at mitigating a public health emergency such as COVID-19. However, the use of technology can expose the public to criminal activities by exposing their locations. From a public governance point of view, any exposure of the public to social ills is highly undesirable. Recommendations for Practitioners: In using contact tracing apps to provide pertinent data location caution needs to be exercised to ensure that sensitive private information is not made public to the extent that it compromises citizens’ safety and security. The study recommends the development and implementation of data use protocols to support the use of this technology, in order to mitigate against infringement of individual privacy and other civil liberties. Recommendation for Researchers: Researchers should explore ways of improving digital applications in order to improve the acceptability of the use of contact tracing technology to manage pandemics such as COVID-19, paying attention to ethical considerations. Impact on Society: Since contact tracing has implications for privacy and confidentiality it must be conducted with caution. This research highlights the challenges that the authorities must address to ensure that the right to privacy and confidentiality is upheld. Future Research: Future research could focus on collecting primary data to provide insight on contact tracing through mining mobile phone location data. Research could also be conducted on how app-based technology can enhance the effectiveness of contact tracing in order to optimize testing and tracing coverage. This has the potential to minimize transmission whilst also minimizing tracing delays. Moreover, it is important to develop contact tracing apps that are universally inter-operable and privacy-preserving.


2008 ◽  
Vol 19 (11) ◽  
pp. 744-746 ◽  
Author(s):  
A Blume ◽  
C Main ◽  
R Patel ◽  
E Foley

There is currently a debate as to whether microscopy is necessary in asymptomatic men presenting for a sexual health screen. Arguments favouring microscopy include finding chlamydia in a significant proportion of sexual partners of men with non-specific urethritis (NSU) in studies that included symptomatic men. We aimed to investigate the proportion of partners of men with asymptomatic NSU who were diagnosed with a sexually transmitted infection. A retrospective case-note review was carried out for all men diagnosed with asymptomatic pathogen-negative NSU, and their traced sexual contacts, during a nine-month period. As a result of contact-tracing, we identified 42 partners who attended the clinic. Only one partner (2.4%) tested positive for chlamydia. A further two partners were diagnosed with a viral sexually transmitted infection (STI). The low level of chlamydia and other STIs in partners of asymptomatic men with pathogen-negative NSU does not support the routine use of microscopy to identify these patients.


2021 ◽  
Author(s):  
Tyler Shelby ◽  
Tyler Caruthers ◽  
Oren Y Kanner ◽  
Rebecca Schneider ◽  
Dana Lipnickas ◽  
...  

BACKGROUND Many have proposed the use of Bluetooth technology to help scale up contact tracing for COVID-19. However, much remains unknown about the accuracy of this technology in real-world settings, the attitudes of potential users, and the differences between delivery formats (mobile app vs carriable or wearable devices). OBJECTIVE We pilot tested 2 separate Bluetooth contact tracing technologies on a university campus to evaluate their sensitivity and specificity, and to learn from the experiences of the participants. METHODS We used a convergent mixed methods study design, and participants included graduate students and researchers working on a university campus during June and July 2020. We conducted separate 2-week pilot studies for each Bluetooth technology. The first was for a mobile phone app (“app pilot”), and the second was for a small electronic “tag” (“tag pilot”). Participants validated a list of Bluetooth-identified contacts daily and reported additional close contacts not identified by Bluetooth. We used these data to estimate sensitivity and specificity. Participants completed a postparticipation survey regarding appropriateness, usability, acceptability, and adherence, and provided additional feedback via free text. We used tests of proportions to evaluate differences in survey responses between participants from each pilot, paired <i>t</i> tests to measure differences between compatible survey questions, and qualitative analysis to evaluate the survey’s free-text responses. RESULTS Among 25 participants in the app pilot, 53 contact interactions were identified by Bluetooth and an additional 61 by self-report. Among 17 participants in the tag pilot, 171 contact interactions were identified by Bluetooth and an additional 4 by self-report. The tag had significantly higher sensitivity compared with the app (46/49, 94% vs 35/61, 57%; <i>P</i>&lt;.001), as well as higher specificity (120/126, 95% vs 123/141, 87%; <i>P</i>=.02). Most participants felt that Bluetooth contact tracing was appropriate on campus (26/32, 81%), while significantly fewer participants felt that using other technologies, such as GPS or Wi-Fi, was appropriate (17/31, 55%; <i>P</i>=.02). Most participants preferred technology developed and managed by the university rather than a third party (27/32, 84%) and preferred not to have tracing apps on their personal phones (21/32, 66%), due to “concerns with privacy.” There were no significant differences in self-reported adherence rates across pilots. CONCLUSIONS Convenient and carriable Bluetooth technology may improve tracing efficiency while alleviating privacy concerns by shifting data collection away from personal devices. With accuracy comparable to, and in this case, superior to, mobile phone apps, such approaches may be suitable for workplace or school settings with the ability to purchase and maintain physical devices.


2019 ◽  
pp. 329-335
Author(s):  
Agnieszka Beata Serwin ◽  
Adriana Grochowska ◽  
Iwona Flisiak

INTRODUCTION. Incidence of syphilis is increasing in Europe in recent years, mainly due to high incidence in men, especially men who have sex with men (MSM). AIM. To analyse sociodemographic, epidemiological and clinical characteristics of men treated for syphilis in Bialystok in 2014 – 2018, to compare these of MSM and men who have sex with women (MSW). MATERIAL AND METHODS. Analysis of age, residency, professional activity, type of sexual contacts (steady vs. casual), marital status, stage of syphilis diagnosed, concomitant sexually transmitted infections (STIs), treatment, partner notification and follow-up attendance. RESULTS. Of 49 male patients with syphilis 26 (53.06%) were MSM and 23 (46.94%) – MSW. The average age was 33.67 and 35.87 years in MSM and MSW patients, respectively. Majority of patients in both groups were residents of urban areas. Tradesmen and those unemployed constituted the highest proportion in MSM and MSW group, respectively. MSM were in majority single and had only casual contacts while MSW, mostly married or engaged in steady relationship, had also casual contacts. Secondary syphilis was most frequently diagnosed in MSM and late latent syphilis - in MSW. Eight patients (16.32%) had concomitant HIV infection, in all diagnosed before syphilis. Contact tracing was successful in 26.92% of MSM and 39.13% of MSW. Follow-up was not done or not completed in half of MSM and more than half of MSW. CONCLUSIONS. Results confirm that MSM play a crucial role in the current epidemics of syphilis. They have mainly casual sexual contacts and have symptomatic infection. In both MSM and MSW contact tracing and follow-up attendance is suboptimal.


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