Disparities in Sexually Transmitted Disease Rates Across the “Eight Americas”

Chesson, Harrell W.; Kent, Charlotte K.; Owusu-Edusei, Kwame; Leichliter, Jami S.; Aral, Sevgi O.

doi:10.1097/olq.0b013e318248e3eb

Cited by 41 publications

(32 citation statements)

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“…All measures we assessed indicated a persistent and high degree of racial/ethnic disparity, consistent with the vast literature documenting these disparities. 1–4 Our findings suggest that a wide range of disparity measures can be useful, individually or as a group, in providing a general overview of the degree of racial/ethnic disparities in STD rates. We found that the disparity measures we examined were generally consistent in assessing trends in disparity in reported STD rates, particularly when looking at changes over a longer time frame (5 years) rather than annual changes.…”

Section: Discussionmentioning

confidence: 86%

“…Racial and ethnic disparities in sexually transmitted disease (STD) rates have been documented extensively, 1–4 and a number of summary measures can be used to quantify these disparities. 2,5–9 For example, the black-to-white rate ratio (e.g., the gonorrhea rate per 100,000 population for blacks divided by that of whites) is commonly used in national STD surveillance reports to illustrate racial/ethnic disparities in reported STD rates.…”

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confidence: 99%

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Trends in Selected Measures of Racial and Ethnic Disparities in Gonorrhea and Syphilis in the United States, 1981–2013

et al. 2016

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Background The purpose of this study was to examine selected measures of racial and ethnic disparities in the reported incidence of syphilis and gonorrhea from 1981 to 2013 in the United States. Methods For each year from 1981 to 2013, we calculated values for five disparity measures (Gini coefficient, two versions of the index of disparity, population attributable proportion, and the black-to-white rate ratio) for five racial/ethnic categories (Non-Hispanic White, Non-Hispanic Black, Hispanic, American Indian/Alaska Native, and Asian/Pacific Islander). We also examined annual and 5-year changes to see if the disparity measures agreed on the direction of change in disparity. Results With a few exceptions, the disparity measures increased from 1981 to 1993 and decreased from 1993 to 2013, whereas syphilis and gonorrhea rates decreased for most groups from 1981 to 1993 and increased from 1993 to 2013. Overall, the disparity measures we examined were highly correlated with one another, particularly when examining 5-year changes rather than annual changes in disparity. For example, all five measures agreed on the direction of change in the disparity of syphilis in 56% of the annual comparisons and in 82% of the 5-year comparisons. Conclusions Although the disparity measures we examined were generally consistent with one another, these measures can sometimes yield divergent assessments of whether racial/ethnic disparities are increasing or decreasing for a given STD from one point in time to another, as well as divergent assessments of the relative magnitude of the change.

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Section: Discussionmentioning

confidence: 86%

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confidence: 99%

Trends in Selected Measures of Racial and Ethnic Disparities in Gonorrhea and Syphilis in the United States, 1981–2013

et al. 2016

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“…Compared to their Caucasian peers, rates of viral and bacterial STIs are elevated several fold according to epidemiological data (1). These data also indicate that racial disparities in STI rates in rural areas are equal to and, in some cases, exceed those found in densely populated inner cities (2). Studies indicate that STI rates in rural communities are affected by the existence of densely interconnected social networks and a restricted pool of dating partners (3, 4).…”

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confidence: 67%

“…The sample was recruited from 11 contiguous rural counties in southern Georgia. These counties were selected based on their non-urban designation by the U.S. Census Bureau, their population density of less than 100 persons per square mile, and elevated rates of sexually transmitted infections compared to rural areas in other parts of the country (2). Eligibility criteria included self-identification as African American, residence in the sampling area, male gender, and age of 19 to 22 years.…”

Section: Methodsmentioning

confidence: 99%

The Influence of Childhood Adversity on Rural Black Men’s Sexual Risk Behavior

2016

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Background Young Black men living in resource-poor rural environments are disproportionately affected by both adverse childhood experiences and HIV/STIs. The influence of childhood adversity on sexual risk behavior remains to be examined among this vulnerable population. Purpose In this study, we investigated the influence of overall adversity as well as three subcomponents, abusive parenting, parental neglect, and witnessing family violence, on men’s engagement in sexual risk behavior. We hypothesized that adverse experiences would predict engagement in sexual risk behaviors including multiple sexual partnerships, inconsistent condom use, frequent sexual activity, and concurrent substance abuse and sexual activity. We tested formally the extent to which defensive relational schemas mediated these associations. Methods Hypotheses were tested with data from 505 rural Black men (M age = 20.29, SD = 1.10) participating in the African American Men’s Health Project. Participants were recruited using respondent-driven sampling Self-report data were gathered from participants via audio computer-assisted self-interviews. Results Bi-factor analyses revealed that, in addition to a common adversity factor, neglect independently predicted sexual risk behavior. Men’s defensive relational schemas partially mediated the influence of the common adversity factor as well as the neglect subcomponent on sexual risk behavior. Conclusions The present research identified a potential risk factor for sexual risk behavior in an understudied and vulnerable population. Adverse childhood experiences in general, and neglect in particular, may place many young Black men at risk for engaging in sexual risk behavior due in part to the influence of these experiences on men’s development of relational schemas characterized by defensiveness and mistrust.

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“…Such speed of processing declines are associated with poorer driving performance and more at-fault crashes in healthy older adults [30,37,38] as well as middle-aged (40+ years) and older adults with HIV [10,13,39,40], which is a growing public health concern [10,13,39]. In the Southern United States, specifically in the Deep South, these points are highly relevant because (1) even with speed of processing declines, adults with HIV must rely on their own driving, especially in rural areas with limited public transportation; and (2) the epicenter of HIV has emerged here in the last decade [41,42], which means many adults with lower socioeconomic status backgrounds and African Americans with HIV will also have HAND [43,44]. Few behavioral interventions have aimed to improve neurocognition in this vulnerable population [45], and pharmacological cognitive interventions produce adverse side effects in a population already experiencing multiple comorbidities [45-50].…”

Section: Introductionmentioning

confidence: 99%

Testing a Computerized Cognitive Training Protocol in Adults Aging With HIV-Associated Neurocognitive Disorders: Randomized Controlled Trial Rationale and Protocol

et al. 2017

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BackgroundHIV-associated neurocognitive disorders occur in nearly 50% of adults with HIV. Such disorders can interfere with everyday functioning such as driving and medication adherence. Therefore, cognitive interventions are needed to address such neurocognitive disorders as well as improve everyday functioning, especially as people age with HIV.ObjectiveThis article reports and discusses the overall rationale and development of speed of processing training, a computerized Internet cognitive training program, to improve this specific neurocognitive ability as well as everyday functioning and quality of life in adults aging with HIV. Although this protocol has been shown to improve speed of processing, everyday functioning, and quality of life in healthy, community-dwelling older adults in the advanced cognitive training in vital elderly (ACTIVE) study, its efficacy in adults aging with HIV has not been established. Nevertheless, such a cognitive intervention is particularly germane as 52%-59% of adults with HIV experience HIV-associated neurocognitive disorders (HAND), and both the frequency and severity of such disorders may increase with advancing age.MethodsThe description of this longitudinal randomized controlled trial covers the following: (1) rationale for speed of processing training in this clinical population, (2) overview of overall study design, (3) eligibility criteria and HAND, (4) intervention dosage, (5) assessment battery, and (6) examination of biomarkers.ResultsThe project was funded in April 2016 and enrolment is on-going. The first results are expected to be submitted for publication in 2020.ConclusionsSimilar novel cognitive intervention approaches are suggested as they may be of value to those with HAND and may utilize similar features of this current randomized controlled trial (RCT) protocol to examine their therapeutic efficacy.Trial RegistrationClinicalTrials.gov NCT02758093; https://clinicaltrials.gov/ct2/show/NCT02758093 (Archived by Webcite at http://www.webcitation.org/6p8C5fBCX)

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Disparities in Sexually Transmitted Disease Rates Across the “Eight Americas”

Cited by 41 publications

References 60 publications

Trends in Selected Measures of Racial and Ethnic Disparities in Gonorrhea and Syphilis in the United States, 1981–2013

Trends in Selected Measures of Racial and Ethnic Disparities in Gonorrhea and Syphilis in the United States, 1981–2013

The Influence of Childhood Adversity on Rural Black Men’s Sexual Risk Behavior

Testing a Computerized Cognitive Training Protocol in Adults Aging With HIV-Associated Neurocognitive Disorders: Randomized Controlled Trial Rationale and Protocol

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