Comparing Sexual Network Mean Active Degree Measurement Metrics among Men who have Sex with Men

• Type of Material: Article
• Authors: Christina Chandra, Emory University; Martina Morris, University of Washington; Connor Van Meter, Emory University; Steven M. Goodreau, University of Washington; Travis Sanchez, Emory University; Patrick Janulis, Northwestern University; Michelle Birkett, Northwestern University; Samuel M. Jenness, Emory University
• Language: English
• Date: 2022-09-14
• Publisher: Wolters Kluwer Health, Inc.
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022 American Sexually Transmitted Diseases Association. All rights reserved.
• Final Published Version (URL): https://doi.org/10.1097/OLQ.0000000000001708
• Title of Journal or Parent Work: Sexually Transmitted Diseases
• Volume: 49
• Issue: 12
• Start Page: 808
• End Page: 814
• Grant/Funding Information: This work was supported by National Institutes of Health grants R21 MH112449 and R01 AI138783, and a grant from the MAC AIDS Fund.
• Keywords: men who have sex with men; parternships; sexually transmitted infection; HIV; Sexual networks
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

Background Mean active degree is an important proxy measure of cross-sectional network connectivity commonly used in HIV/STI epidemiology research. No current studies have compared measurement methods of mean degree using a cross-sectional study design for men who have sex with men (MSM) in the United States. We compared mean degree estimates based on reported ongoing main and casual sexual partnerships (current method) against dates of first and last sex (retrospective method). Methods We used data from ARTnet, a cross-sectional survey of MSM in the U.S. (2017–2019). ARTnet collected data on the number and types of sexual partners in the past year, limited to the 5 most recent partners (data truncation). We quantified partnerships for months 0–12 prior to the survey date (retrospective method), and compared that to ongoing partnerships on the day of survey (current method). We used linear regression to understand the impact of truncated partnership data on mean degree estimation. Results The retrospective method yielded similar degree estimates to the current for months proximate to the day of survey. The retrospective method mean degree systematically decreased as the month increased from 0–12 months prior to survey date. This was driven by data truncation: among participants with >5 partners in the past year compared to those with ≤5, the average change in main partnership degree between 12 and 0 months prior to survey date was −0.05 (95% CI: −0.08, −0.03) after adjusting for race/ethnicity, age, and education. The adjusted average change in casual partnership degree was −0.40 (95% CI: −0.45, −0.35). Conclusions The retrospective method underestimates mean degree for MSM in surveys with truncated partnership data, especially for casual partnerships. The current method is less prone to bias from partner truncation when the target population has high rate of partners per year.