Article Text

PDF
Republished paper: Populations and partnerships: insights from metapopulation and pair models into the epidemiology of gonorrhoea and other sexually transmitted infections
  1. Mark I Chen1,2,3,
  2. Azra C Ghani4
  1. 1Department of Clinical Epidemiology, Tan Tock Seng Hospital, Singapore
  2. 2Duke-NUS Graduate Medical School, Singapore
  3. 3Department of Epidemiology and Public Health, National University of Singapore, Singapore
  4. 4Division of Epidemiology, Public Health and Primary Care, Imperial College London, London, UK
  1. Correspondence to Mark I Chen, Department of Clinical Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng 308433, Singapore; mark_ic_chen{at}ttsh.com.sg

Abstract

Background Models of sexually transmitted infection (STI) transmission can offer insights as to why gonorrhoea and other STIs are disproportionately concentrated in epidemiologically distinct subpopulations.

Methods We highlight two different constructs for modelling STIs by drawing on previously published work on pair and metapopulation models, and reanalysed partnership data from the National Survey of Sexual Attitudes and Lifestyles II (NATSAL II) in the UK.

Results Pair models account for intrapair reinfections and are necessary to illustrate the importance of partnership dynamics. The pair modelling framework suggests that a key determinant of transmission is the length of time or ‘gap’ between partnerships, and that partnerships of medium length can potentially be more efficient for gonococcal transmission than the shortest partnerships. As for the metapopulation framework, one key insight is that the epidemiology of gonorrhoea is possibly being driven by subpopulations with higher than average concentrations of individuals with high sexual risk activity. The reanalysis of data on sexual behaviour in the UK shows that well recognised population subgroups at higher risk of gonorrhoea do also have higher levels of risk behaviour, such as a higher average number of new partners per year, as well as a higher prevalence of concurrent partnerships and short gaps before partnerships.

Results The concentration of risk behaviour in key population subgroups may be leading to self-sustaining pockets of transmission for STIs. Combinations of partnership behaviours at the level of population subgroups should be a subject of future empirical research as well as modelling efforts.

  • Sexual networks
  • mathematical model
  • gonorrhoea
  • epidemiology
  • sexual behaviour
  • Neisseria gonorrhoea

Statistics from Altmetric.com

Footnotes

  • This article was previously published in the November issue, Sex Transm Infect 2010;86:433–439.

  • Funding MIC was partially funded by the ExxonMobil-NUS Research Fellowship.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.