Exploring the Role of Social Network Structure in Disease Risk among U.S. Long-haul Truck Drivers in Urban Areas.

Using mixed methods, we explored properties of long-haul truckers' social networks potentially influencing STI/BBI acquisition and transmission. We recruited inner-city drug and sex network members (N = 88) for interviews. Blood and urine samples and vaginal swabs were collected to test for STIs/BBIs. Data were collected on participants' role in the network (trucker, sex worker, or intermediary), sexual and substance-use behaviors, and dyadic relationships with drug and/or sex contacts. We analyzed network data using UCINET. Data revealed 2 major network clusters (58 male truckers, 6 male intermediaries, and 24 female sex workers; 27.3% STI/BBI positive). Overall, 18.8% of network members had more than one type of risky relationship with the same person (multiplexity), 11.4% of dyads were between 2 STI/ BBI positive people (assortative mixing), 36.4% were between one STI/BBI positive person and one negative person (disassortative mixing), 44.3% of people were connected to more than one person who was STI/BBI positive (concurrency), and 62.5% of nodes were just one path removed from an STI/BBI positive individual (bridging). Despite only 27.3% of the network being STI/BBI positive, our results revealed network characteristics (and potential intervention points) that amplify risk of disease spread within trucker-centered networks.