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A network view of the transmission of sexually transmitted infections in Manitoba, Canada
  1. John L Wylie1,2,3,
  2. Souradet Shaw3,
  3. Emily DeRubeis4,
  4. Ann Jolly5
  1. 1Cadham Provincial Laboratory, Manitoba Health, Winnipeg, Manitoba, Canada
  2. 2Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
  3. 3Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
  4. 4Health Information, Analysis and Research Division, First Nations and Inuit Health, Health Canada, Ottawa, Ontario, Canada
  5. 5Surveillance and Risk Assessment Division, Centre for Communicable Disease and Infection Control, Infectious Disease Emergency Preparedness Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada
  1. Correspondence to Dr John Wylie, Cadham Provincial Laboratory, 750 William Avenue, Winnipeg, Manitoba R3E 3J7, Canada; john.wylie{at}


Diez Roux has used the concept of complex systems to describe approaches for the incorporation of social factors into health research. These systems consist of heterogeneous interdependent units that also exhibit emergent properties. The latter embodies the concept that the interdependent units interact with and affect each other such that the resulting properties are not simple aggregates of the individual-level properties. This paper reviews research from Manitoba with a view towards conceptualising and phrasing the observed patterns within a complex system framework. A review of the temporal and spatial patterns seen within two large sexual network databases from Manitoba was undertaken and framed against the overlying patterns of sexually transmitted infection (STI) transmission within Manitoba. The review includes a summation of STI epidemiological patterns in Manitoba over a 5-year time frame, a comparison of temporal sexual network patterns, and an analysis of network patterns in relation to disparity in STI rates. Hypotheses are generated that focus on how individual-level behaviours and interactions create the observed complex system (network) patterns.

  • Chlamydia trachomatis
  • Neisseria gonorrhoeae
  • sexual networks

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  • Funding This study was funded by the Canadian Institutes of Health Research.

  • Competing interests None declared.

  • Ethics approval This study was conducted with the approval of the University of Manitoba Health Research Ethics Board.

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