The purpose of this study was to examine the difference in the number of syphilis cases detected by social network analysis (SNA) interviews compared to partner notification interviews and describe the sexual and social networks of syphilis cases Ten primary and secondary syphilis index cases were enrolled in the social network study. The index cases and two more generations of contacts were interviewed using an innovative game board. Social network data collection occurred from 8/1/96-1/31/96 in one urban parish and three rural parishes. Infected syphilis cases agreed to receive the social network interview in place of the partner notification interview. Seventy-two PN cases were collected from 1/1/96-6/30/96 from the same parishes. SNA collects detailed information on sexual and social relationships that PN does not. Statistical comparisons were conducted between the PN and the SNA interviews. Within group analyses were also conducted There were no differences with respect to the mean number of syphilis infected contacts between the PN and SNA interviews (PN mean = 0.24, SNA mean = 0.38, NS). Social contacts from the SNA had a zero yield of syphilis positivity. Sexual and social networks were diffuse and disaggregated. Fifteen percent of the sexual contacts were also members of respondent's social groups It is not practical to conduct a full scale SNA as a routine procedure in place of PN because SNA interviews are time intensive and the analysis is mathematically complex. The PN program may be improved by incorporating elements of the social network interview and analysis. In a network informed approach to STD control, PN interviewers could focus their efforts at a particular neighborhood in order to understand the neighborhood structure This study has identified a diffuse and disaggregated group of individuals that are at 'moderate' risk for syphilis and other STDs. This study revealed a community of many persons with a couple or a few sexual partners, high rates of self reported STDs and similar network placement in their specific community structures. In addition to 'high risk' target groups, groups of persons at 'moderate risk' identified by SNA should also be the target of STD control
