Risk Pathways for Gonorrhea Acquisition in Sex Workers: Can We Distinguish Confounding From an Exposure Effect Using A Priori Hypotheses?
Author(s)
Gomez, GB
Ward, H
Garnett, GP
Type
Journal Article
Abstract
The population distribution of sexually transmitted infections (STIs) varies broadly across settings. Although
there have been many studies aiming to define subgroups at risk of infection that should be a target for prevention
interventions by identifying risk factors, questions remain about how these risk factors interact, how their
effects jointly influence the risk of acquisition, and their differential importance across populations. Theoretical
frameworks describing the interrelationships among risk determinants are useful in directing both the design
and analysis of research studies and interventions. In this article, we developed such a framework from a review
looking at determinants of risk for STI acquisition, using gonorrhea as an index infection. We also propose an
analysis strategy to interpret the associations found to be significant in uniform analyses of observational data.
The framework and the hierarchical analysis strategy are of particular relevance in the understanding of risk
formation and might prove useful in identifying determinants that are part of the causal pathway and therefore
amenable to prevention strategies across populations.
there have been many studies aiming to define subgroups at risk of infection that should be a target for prevention
interventions by identifying risk factors, questions remain about how these risk factors interact, how their
effects jointly influence the risk of acquisition, and their differential importance across populations. Theoretical
frameworks describing the interrelationships among risk determinants are useful in directing both the design
and analysis of research studies and interventions. In this article, we developed such a framework from a review
looking at determinants of risk for STI acquisition, using gonorrhea as an index infection. We also propose an
analysis strategy to interpret the associations found to be significant in uniform analyses of observational data.
The framework and the hierarchical analysis strategy are of particular relevance in the understanding of risk
formation and might prove useful in identifying determinants that are part of the causal pathway and therefore
amenable to prevention strategies across populations.
Date Issued
2014-12-01
Date Acceptance
2014-12-01
Citation
Journal of Infectious Diseases, 2014, 210, pp.S579-S585
ISSN
1537-6613
Publisher
Oxford University Press (OUP)
Start Page
S579
End Page
S585
Journal / Book Title
Journal of Infectious Diseases
Volume
210
Copyright Statement
© The Author 2014. Published by Oxford University Press on behalf of the Infectious
Diseases Societyof America. This is an Open Access article distributed undertheterms
of the Creative Commons Attribution License (http://creativecommons.org/licenses/
by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any
medium, provided the original work is properly cited
Diseases Societyof America. This is an Open Access article distributed undertheterms
of the Creative Commons Attribution License (http://creativecommons.org/licenses/
by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any
medium, provided the original work is properly cited
License URL
Subjects
Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Microbiology
framework
gonorrhea
sex workers
risk of acquisition
PROXIMATE-DETERMINANTS FRAMEWORK
SEXUALLY-TRANSMITTED-DISEASES
GONOCOCCAL-INFECTION
EPIDEMIOLOGY
HIV
EXPLANATION
PROMOTION
ZIMBABWE
SPREAD
HEALTH
Publication Status
Published