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PublicHealthOntario.ca

Social networks and their analysis: HIV, STIs and beyond
James Iveniuk
Post-doctoral researcher
Dalla Lana School of Public Health
University of Toronto
PHO Grand Rounds
October 27th

• Objective 1: Describe a network perspective on the study of STIs, with a focus on HIV.
• Objective 2: Provide an overview of selected popular methods for gathering and using network data to study STIs.
• Objective 3: Demonstrate the utility of a network perspective for policy and public health intervention, including and beyond HIV.

SPOKE WHEEL

SPOKE WHEEL
(in this graph, sexual partnership over some period of time)

SPOKE WHEEL
(in this graph, people)

through this network if many of these are concurrent relationships (Morris and
Kretzschmar, 1997).
• What about the partners of the partners?

through this network if many of these are concurrent relationships (Morris and
Kretzschmar, 1997).
• What about the partners of the partners?

Two different network structures
SPOKE WHEEL

Two different network structures
1
SPOKE WHEEL
2
2
1

Two different network structures
1
SPOKE WHEEL
2
2
1
The shortest path from node 1 to 2, in each network.

Black vs. white HIV rates:
A network explanation
R
E
G
A
T
I
O
N
S
E
G
Adapted from:
Laumann and Youm, 1999

Black vs. white HIV rates:
A network explanation
R
E
G
A
T
I
O
N
S
E
G
Adapted from:
Laumann and Youm, 1999

Black vs. white HIV rates:
A network explanation
R
E
G
A
T
I
O
N
S
E
G
Adapted from:
Laumann and Youm, 1999

MSM Sex networks in the South Side of Chicago
From:
Shah and Iveniuk et al., 2014

MSM Sex networks in the South Side of Chicago
From:
Shah and Iveniuk et al., 2014

Source:
Toronto
Connected Lives
Study

Source:
The National Social Life Health and Aging Project
See also:
Burt, 1984; Marsden, 1987; McPherson, Smith-Lovin and Brashears, 2007; Paik and Sanchagrin, 2013

Source:
The National Social Life Health and Aging Project
See also:
Burt, 1984; Marsden, 1987; McPherson, Smith-Lovin and Brashears, 2007; Paik and Sanchagrin, 2013

What can name generators discover?
Findings from a national sample
2005 2010
• Little to no shrinkage of discussion networks with age
(Cornwell et al. 2008;
Cornwell and
Laumann 2015).
• Most older adults are sexually active (Lindau et al. 2007; Waite and
Iveniuk et al. 2015); rates of concurrent partners vary strongly by racial group
(Harawa 2011).

What can name generators discover?
Findings from a national sample
2005 2010
• Little to no shrinkage of discussion networks with age
(Cornwell et al., 2014;
Cornwell and
Laumann, 2015).
• Most older adults are sexually active (Lindau et al. 2007; Waite and
Iveniuk et al. 2015); rates of concurrent partners vary strongly by racial group
(Harawa 2011).

What can name generators discover?
Findings from a national sample
2005 2010
• Little to no shrinkage of discussion networks with age
(Cornwell et al., 2014;
Cornwell and
Laumann, 2015).
• Many older adults are sexually active (Lindau et al., 2007; Waite and
Iveniuk et al., 2015); rates of concurrent partners vary strongly by racial group
(Harawa, 2011).

From:
Heckathorn,
1997

Seed
From:
Heckathorn,
1997

RDS Coupon Network
• Overlay of Facebook links on the
RDS sample links
• 63 of 397 (16%) RDS links are also Facebook friendships
N=458
Size: number of recent sex partners
Node Color: Facebook data
Does not exist Exists
Link Color: Facebook friendships
Friends
Facebook Users versus
Integrating Facebook in a
Population Based Survey
Facebook chain
Non-Facebook chain

ergm

A national study of HIVserodiscordant couples, fielded by the SRC at
UToronto’s Dalla Lana
School of Public Health.
By only theorizing the person living with HIV, we neglect the HIV-negative person, and the relationship as a whole.
Linked to an extensive knowledge translation project.

A national study of HIVserodiscordant couples, fielded by the SRC at
UToronto’s Dalla Lana
School of Public Health.
By only theorizing the person living with HIV, we neglect the HIV-negative person, and the relationship as a whole.
Linked to an extensive knowledge translation project.

A national study of HIVserodiscordant couples, fielded by the SRC at
UToronto’s Dalla Lana
School of Public Health.
By only theorizing the person living with HIV, we neglect the HIV-negative person, and the relationship as a whole.
Linked to an extensive knowledge translation project.

From:
Bearman,
Moody and
Stovel, 2004

The partnership network of a mid-size
American high school (573 students)

NOTE:
X’s denote activity locations. Gray ellipses denote specific activity location clusters. Dashed lines represent neighbourhood boundaries.
Source: Browning, Soller, and Jackson, 2015
• For neighbourhoods where households were more connected by shared activity spaces, youths from those neighbourhoods’ households were less likely to have had sex, or engage in substance use (Browning, Soller and Jackson, 2015).

The potential for network interventions
Network members can be selected based on network position to become change agents.
Source: Valente, 2010

The potential for network interventions
Source: Valente, 2010
Network members can be selected based on network position to become change agents.
In a study of MSM in Southern
India, Schneider et al., 2015 found that people in bridging positions were more innovative, and had less risky behavior than existing peer educators.

A recipe for crafting a social network intervention
1. Collect social network data on your population
2. Compute indexes for social network position
3. Recruit/train people in appropriate network positions
4. Evaluate and test the intervention
5. Scale up

Social networks have been linked to a considerable range of health outcomes

Odds (lnOR) of decreased mortality across several conditions associated with mortality.
Social relationships (overall)
High vs. low social support
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8
High vs. low social integration
Smoking <15 cigarettes / day
Smoking cessation in patients with CVD
Adapted from: Holt-Lunstad, Smith and Layton, 2010

Odds (lnOR) of decreased mortality across several conditions associated with mortality.
Social relationships (overall)
High vs. low social support
0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8
High vs. low social integration
Smoking <15 cigarettes / day
Smoking cessation in patients with CVD
Adapted from: Holt-Lunstad, Smith and Layton, 2010

Size of node is proportional to BMI; yellow nodes are obese. Purple ties are marital/ friendship and green are family.
Source: Christakis and Fowler, 2007.
Also see:
VanderWeele, 2011

From:
Schaefer, Kornienko, and
Fox, 2011
See also:
Bearman and Moody, 2004 on suicide.

A NETWORKED FUTURE
FOR PUBLIC HEALTH
Take-away points:
- Human health is always produced in social relationships.
- Treating individuals may be limited; treat social structure , in the form of networks.
- Pursue new methods, theory, and data , to design better policy and public health interventions.

Technology for collecting network data, and identifying change agents
Subscriber Identity Module (SIM) card reader. The SIM card reader was assembled using a kit from Adafruit Industries (New
York, NY).
Source: Schneider et al. 2015
Digital communication network of MSM respondents ( n = 241; 706 ties). Ties are designated by blue for social and green for sex. Inset network is of the augmented network which includes MSM respondents and all MSM from respondent cell phone contact lists ( n = 4991; 6458 ties).

• Other possible measures: Link deletion, betweenness centrality.

Innovativeness (Hurt et al., 1977)
Hurt, H. T., Joseph, K.,& Cook, C. D. Scales for the measurement of innovativeness. Human
Communication Research, 4, 58-65.
I am generally cautious about accepting new ideas
Strongly Disagree Strongly Agree
1 2 3 4 5
I rarely trust new ideas until I can see whether the vast majority of people around me accept them.
Strongly Disagree Strongly Agree
1 2 3 4 5
I am aware that I am usually one of the last people in my group to accept something new.
Strongly Disagree Strongly Agree
1 2 3 4 5
I am reluctant about adopting new ways of doing things until I see them working for people around me.
Strongly Disagree Strongly Agree
1 2 3 4 5
I find it stimulating to be original in my thinking and behavior.
Strongly Disagree Strongly Agree
1 2 3 4 5
I tend to feel that the old way of living and doing things is the best way.
Strongly Disagree Strongly Agree
1 2 3 4 5
I am challenged by ambiguities and unsolved problems.
Strongly Disagree Strongly Agree
1 2 3 4 5
I must see other people using new innovations before I will consider using them.
Strongly Disagree Strongly Agree
1 2 3 4 5
I am challenged by unanswered questions.
Strongly Disagree Strongly Agree
1 2 3 4 5
I often find myself skeptical of new ideas.
Strongly Disagree Strongly Agree
1 2 3 4 5

Bridging – Schneider-Laumann; unpublished
I have many groups of friends who don’t know each other.
Strongly Disagree Strongly Agree
1 2 3 4 5
I usually hear about new things from one group of friends before another group does.
Strongly Disagree Strongly Agree
1 2 3 4 5
Many of my friends don’t know one another.
Strongly Disagree Strongly Agree
1 2 3 4 5
I would not want to recommend a new HIV prevention technique to my group of friends?
Strongly Disagree Strongly Agree
1 2 3 4 5
All of my friends know one another.
Strongly Disagree Strongly Agree
1 2 3 4 5
I am more concerned with what I believe is right than what my friends think.
Strongly Disagree Strongly Agree
1 2 3 4 5
Do you think of yourself as a connector that links different groups of friends together, or are you more of a leader within one group?
Connector Leader within Group
1 2 3 4 5

• Intervention using peer opinion leaders
• Kelly et al. 1991

From:
Cornwell and Waite 2011

Source: Cagney, Browning, Jackson, Stoller 2013

Source: Morris et al. 2009

Source: Morris et al. 2009

Source: Birkett et al. 2015

Positivity in relation to the Big Five
Source: Iveniuk et al. 2014

A husband’s Positivity is associated with his wife’s reports of conflict, but not vice versa
*
*
*
Controls for: age, ethnicity, education, physical health, mental health, years cohabiting.
Source: Iveniuk et al. 2014

Husbands’ and wives’ Neuroticism was associated with increased conflict, according to their partners
*
*
Controls for: age, ethnicity, education, physical health, mental health, years cohabiting.
Source: Iveniuk et al. 2014

A husband’s health is associated with his wife’s reports of conflict, but not vice versa
*
*
Spouse's health
Source: Iveniuk et al. 2014
Spouse's health

Social network size in Wave One of
NSHAP
• Older adults also have more family named in their networks.
• Age was also negatively associated with closeness to confidants.
Source: Cornwell, Laumann and Schumm. 2008.

Changes in connectedness over time
*
*
*
*
*
*
*
*
●●●●○○○○○○○○○○○○○○○○○○○○○

Men were less likely to talk to their family about health over time
*
*
*

Associations between Extraversion and network characteristics of older adults
*
*
*
*
*
*
*
*
*
Controls for: age, gender, ethnicity, education, phys. hlth, retired, married, lagged dependent variable.
Source: Iveniuk, under review.

• No significant associations between traits and density.
• More Neurotic people were also more likely to talk to their friends about their health.
• Agreeableness (closeness, time spent with confidants) was not affected by rolerelationships with confidants.

Source: Rentfrow, Gosling, and Potter, 2008
Social networks and personality

Sexual activity in older adulthood
SOURCE: Lindau, ST., LP Schumm, EO Laumann, W Levinson, C O’Muircheartaigh, LJ Waite. 2007. “A study of sexuality and health
Among older adults in the United States.” N Engl J Med 357: 762-774 .

* male
* female male
* female male female male female
• Controls for: age, ethnicity, education, marital status, retirement.
●●●●○○○○○○○○○○○○○○○○○○○○○

* male
* female male
* female male female male female
• Controls for: age, ethnicity, education, marital status, retirement.
●●●●○○○○○○○○○○○○○○○○○○○○○

*
* male
* female male
* female male female male female
• Controls for: age, ethnicity, education, marital status, retirement.
●●●●○○○○○○○○○○○○○○○○○○○○○

Pescosolido, 2006