An assessment of preferential attachment as a mechanism for human sexual network formation

Recent research into the properties of human sexual-contact networks has suggested that the degree distribution of the contact graph exhibits power-law scaling. One notable property of this power-law scaling is that the epidemic threshold for the population disappears when the scaling exponent rho is in the range 2 < rho < or = 3. This property is of fundamental significance for the control of sexually transmitted diseases (STDs) such as HIV/AIDS since it implies that an STD can persist regardless of its transmissibility. A stochastic process, known as preferential attachment, that yields one form of power-law scaling has been suggested to underlie the scaling of sexual degree distributions. The limiting distribution of this preferential attachment process is the Yule distribution, which we fit using maximum likelihood to local network data from samples of three populations: (i) the Rakai district, Uganda; (ii) Sweden; and (iii) the USA. For all local networks but one, our interval estimates of the scaling parameters are in the range where epidemic thresholds exist. The estimate of the exponent for male networks in the USA is close to 3, but the preferential attachment model is a very poor fit to these data. We conclude that the epidemic thresholds implied by this model exist in both single-sex and two-sex epidemic model formulations. A strong conclusion that we derive from these results is that public health interventions aimed at reducing the transmissibility of STD pathogens, such as implementing condom use or high-activity anti-retroviral therapy, have the potential to bring a population below the epidemic transition, even in populations exhibiting large degrees of behavioural heterogeneity.