Network studies are an increasingly important source of evidence explaining the movement of sexually transmitted infections (STIs) through at-risk populations. This design type complements traditional epidemiological measures by incorporating spatial and temporal data about people’s social and sexual connections to evaluate the spread of STIs. This applied presentation describes the speaker’s experience initiating a multi-site sexual network study of syphilis transmission among men who have sex with men (MSM) in an LGBTQ-friendly Midwestern US city. She discusses challenges and field-tested solutions specific to chain-referral network studies across multiple domains, including: 1. ethical review, which required extensive education of IRB members and changes to local IRB policy prior to approval; 2. feasibility and acceptability, which required community engagement and sensitization to assuage participant concerns about confidentiality in the use of peer referrals and with the enumeration of sexual partners using modified identifiers; and, 3. data capture, including management challenges inherent to tracking sexual partners and behaviors over time, in the context of changing relationships (e.g., evolution and devolution of relationships from anonymous to casual to primary to dissolved to reinitiated), changing disease exposure, and use of a smartphone app to capture inter-visit behavioral risk data. She describes strategies used prior to and after study initiation to develop, maintain and enhance relationships with the target community, and future plans for continued engagement around dissemination of results. Accurate measurement of sensitive or stigmatized behavior presents a challenge to the validity of nearly all STI research. Maximizing the acceptability, feasibility and validity of network studies will lead to more accurate estimates of the drivers of STI transmission and will provide more valid insights about the opportunities for interventions to prevent and control STI outbreaks.

Disclosure No significant relationships.