Using Social Network Analysis to Plan a Focused Intervention for Meth-Using MSM in Indianapolis, in

Background: The Indianapolis MSA (District 5) has had a steady rise in syphilis for several years and comprises the largest share of morbidity in the state, reporting 133 P&S cases and 119 early latent cases in 2015. Due to the number of confirmed cases reporting Meth use during interviews with DIS, a social network map of meth related cases was constructed in order to target focused interventions to stop disease transmission.  

Methods: Over 100 individuals were charted on this sociogram, including early syphilis, HIV, and those who received preventive treatment. Through the network analysis, 60 individuals were identified for targeted outreach based on the number of links on the sociogram, previous history of syphilis, and lack of current RPR tests within a 3 month window. Over a three week period, teams of two DIS conducted outreach and field testing of HIV, STD and Hep C when patients were located. 

Results: Out of the 60 people that were identified as the highest at risk, only 20 were able to be found or agreed to testing. We also found success testing at a P.O.L.’s (Popular Opinion Leaders) house. Out of 36 people tested, we found three new early syphilis cases, two new HIV cases, five new positive chlamydia tests, six new positive gonorrhea tests, and two Hepatitis C positive individuals were found. All of the positive CT/GC tests were either in the throat or rectum, all individuals claiming to be asymptomatic.

Conclusions: Through this focused outreach, we were not only very successful in case finding, but we were also able to gain more trust within the MSM methamphetamine-using community, normally a group that is challenging to reach in Indianapolis.