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Spatial bridges for the importation of gonorrhea and chlamydial
infection.
Sexually Transmitted Diseases 2003; 30(10):742-749.
Kerani RP, Golden MR, Whittington WLH, Handsfield HH, Hogben
M, Holmes
KK.
Abstract
A study of heterosexuals with gonorrhea and/or chlamydial infection in King
County, Washington, found that 5.2% of study participants had both local
and geographically distant sex partners in the 60 days before diagnosis.
Individuals who served as spatial bridges were of higher socioeconomic status
and older than other patients. BACKGROUND: Sexual mixing between distant
geographic areas (spatial bridging) is important in the spread of antimicrobial
resistance and new sexually transmitted disease pathogens. GOAL: The goal
was to define the extent of sexual mixing between persons with gonorrhea
or chlamydial infection in King County, Washington, and persons outside the
Seattle area, and to identify characteristics of persons and partnerships
associated with spatial bridging. METHODS: Patients contacted for purposes
of partner notification were interviewed regarding demographics, sexual behavior,
and the characteristics of their sex partners. RESULTS: Of 2912 participants,
150 (5.2%) were spatial bridgers. Bridgers were of higher socioeconomic status
than nonbridgers and more often reported concurrent partnerships. Over a
39-month period, bridgers and potential bridgers linked King County with
35 states and 13 foreign countries. CONCLUSION: Spatial bridging could represent
an important channel of transmission between geographic areas. These results
highlight the need for linkage of prevention efforts across geographic boundaries.