Dynamics of Neisseria gonorrhoeae transmission among female sex workers and clients: A mathematical modeling study.

Ayoub, Houssein H; Tomy, Milan; Chemaitelly, Hiam; Omori, Ryosuke; Buse, Kent; Low, Nicola; Hawkes, Sarah; Abu-Raddad, Laith J (2024). Dynamics of Neisseria gonorrhoeae transmission among female sex workers and clients: A mathematical modeling study. Epidemics, 48(100785), p. 100785. Elsevier 10.1016/j.epidem.2024.100785

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BACKGROUND

This study aimed to examine the transmission dynamics of Neisseria gonorrhoeae (NG) in heterosexual sex work networks (HSWNs) and the impact of variation in sexual behavior and interventions on NG epidemiology.

METHODS

The study employed an individual-based mathematical model to simulate NG transmission dynamics in sexual networks involving female sex workers (FSWs) and their clients, primarily focusing on the Middle East and North Africa region. A deterministic model was also used to describe NG transmission from clients to their spouses.

RESULTS

NG epidemiology in HSWNs displays two distinct patterns. In the common low-partner-number HSWNs, a significant proportion of NG incidence occurs among FSWs, with NG prevalence 13 times higher among FSWs than clients, and three times higher among clients than their spouses. Interventions substantially reduce incidence. Increasing condom use from 10 % to 50 % lowers NG prevalence among FSWs, clients, and their spouses from 12.2 % to 6.4 %, 1.2 % to 0.5 %, and 0.4 % to 0.2 %, respectively. Increasing symptomatic treatment coverage among FSWs from 0 % to 100 % decreases prevalence from 10.6 % to 4.5 %, 0.8 % to 0.4 %, and 0.3 % to 0.1 %, respectively. Increasing asymptomatic treatment coverage among FSWs from 0 % to 50 % decreases prevalence from 8.2 % to 0.4 %, 0.6 % to 0.1 %, and 0.2 % to 0.0 %, respectively, with very low prevalence when coverage exceeds 50 %. In high-partner-number HSWNs, prevalence among FSWs saturates at a high level, and the vast majority of incidence occurs among clients and their spouses, with a limited impact of incremental increases in interventions.

CONCLUSION

NG epidemiology in HSWNs is typically a "fragile epidemiology" that is responsive to a range of interventions even if the interventions are incremental, partially efficacious, and only applied to FSWs.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Low, Nicola

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1755-4365

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

07 Aug 2024 11:39

Last Modified:

17 Sep 2024 00:15

Publisher DOI:

10.1016/j.epidem.2024.100785

PubMed ID:

39106639

Uncontrolled Keywords:

Epidemiology Female sex workers Mathematical model Neisseria gonorrhoeae Sex work Sexual behavior

BORIS DOI:

10.48350/199546

URI:

https://boris.unibe.ch/id/eprint/199546

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