NEW YORK CITY, 30 November 2012 (PlusNews) – With whom did you last have sex? When? Where? How? At crowded food stalls and in dimly lit bars, Kelvin Parker carries out what HIV researchers call “sexual networking mapping”.
Networking analysis involves getting intimate details from people who are most at risk of HIV infection to slow the spread of sexually transmitted infections.
Parker, a 48-year-old former prison inmate in the US with a stocky frame and husky laugh, has no academic degrees or knowledge of “fancy math”. But what he does know is how to approach strangers in public places, hang out with them over weeks, gain their trust, and then, talk sex.
A researcher in an upcoming study by Georgia State University on the spread of HIV in Tanzania, Parker said whether in the US or Tanzania, the method is the same: “I’ll talk to anyone and everyone, the same way I always do. I’ll build a rapport with people who gather in places where men have sex with men (MSM). Then I’ll tell people I want to talk to men in this group -and their sexual partners, too – about how they’re connected socially so we can home in on their social networks and work to stop the spread of HIV.”
Parker, who has never done field work overseas before, is part of the small but growing field of sexual network mappers, which explores the spread of sexually transmitted infections (STIs) through socio-geographic factors (such as places, people and practices) instead of looking only at a person’s sexual behaviour independent of community factors.
Experts say this decades-old but rarely used approach could help address – and eventually slow – the spread of STIs. But first, its advocates must overcome stubborn obstacles, such as the extra time and expertise required, as well as concerns of privacy invasion and confidentiality breaches that have prevented sexual network mapping from being more widely utilized until recently.
Targeting at-risk groups
Sexual network mapping identifies and targets groups at high risk of STIs because they frequent a particular place (such as a certain nightclub), belong to a particular at-risk group (such as MSM and sex workers), and/or engage in risky behaviours (injecting drugs and sharing needles with men infected with HIV).
This data collection method started in the late 1970s, when health workers in Colorado Springs, a small city in the western US, were studying the STIs, gonorrhoea and syphilis. “We noticed that some people who were very sexually active never got infected, while others who were less promiscuous contracted disease more frequently,” said John Potterat, an epidemiologist formerly with the US Centres for Disease Control and Prevention who was involved in this early research.
When Potterat and his colleagues started asking people who had STIs about personal behaviours, they made a surprising discovery: of the 300-odd night spots in Colorado Springs, six were associated with half of total infections. “We learned it was geography or where people hooked up that determined their STI risk,” said Potterat.
The Colorado Springs team began doing “contact tracing”, which included asking STI-positive people to reveal the names of their partners in order to find others at risk. Name by name, Potterat and his colleagues mapped out the “network” of people who were transmitting STIs in relation to the town’s six hot spots. Then, they offered safe-sex counselling and pamphlets to people connected to this network – anyone who was having sex with someone attending one of the six night clubs. Over the course of 15 years, they helped lower rates of STI infection by 25 to 40 percent in the city.
This was the same research method that revealed how HIV was spread in the US in the early 1980s through gay men living primarily in San Francisco and New York City.
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