Syndemics of Sexually Transmitted Infections in a Sample of Racially Diverse Pregnant Young Women

Abstract

Introduction Syndemic theory posits that poor health outcomes co-occur and amplify each other in the context of harmful conditions that must be addressed simultaneously to improve health equity. This analysis identifies perinatal syndemic factors and examine how factors are related to STI in a sample of racially diverse young pregnant women. Methods Pregnant participants (n = 61) ages 14-21 from racially diverse backgrounds were recruited from a prenatal clinic for an ongoing longitudinal study between October 2019-February 2020. Participants completed a tablet survey assessing pregnancy intention, psychosocial factors (e.g., depression, stress, partner violence, pregnancy history) and consented to provide access to their medical records for STI and clinical urine samples screened for tobacco and cannabis use. Latent class analysis (LCA) was used to examine probabilities of co-occurring Syndemic indicators. Results Half of the women were Black (52%) and primigravida (54%). Three classes were identified in the LCA, two of them reflecting syndemics related to STI from the medical record. The largest class was half Black (51%), with a high rate of STI (65%), and was characterized by factors including depressive symptoms (93%), stress (64%), and substance use (65% cannabis, 82% tobacco). Additionally, the class with the highest rates of STI (74%) also had higher rates of partner violence (48%), morning sickness (100%), and prenatal cannabis use (63%). Conclusion Findings indicate evidence of a syndemic related to increased STI. A longitudinal evaluation of syndemics in this cohort may inform appropriately tailored intervention strategies to promote perinatal health in racially diverse young pregnant populations.

Pandemic stressors and vaccine hesitancy among young, pregnant Black people: A qualitative study of health disparities during a global pandemic

“…One encouraging result was that many participants mentioned positive coping mechanisms such as listening to their favorite music, playing with their children, completing household tasks, and writing. None of the participants reported using cannabis to cope with stress, even though prenatal cannabis use was correlated with prenatal stress and depressive symptoms in the YoungMoms study (Hill et al, 2022) and prenatal cannabis use increased during the pandemic in other studies (Young-Wolff et al, 2021). Our interview prompt "what about smoking or drinking?"…”

Disparities in Prenatal Sexually Transmitted Infections among a Diverse Population of Foreign-Born and US-Born Women

“…In our study, FB women were more likely to identify as racial/ethnic minorities, have less time living in the USA, have a high school education or less, were lower income, and had more people in their household. It is likely that FB pregnant women in the USA have more unaddressed social determinants of health compared to US-born women that influence their health outcomes for a myriad of reasons [28,29]. Although not the focus of this investigation, exploring the context of pregnant FB women's lived experiences during transition to the USA and after, in relation to their STI risk will be helpful to tailor strategies that address the specific needs of FB perinatal populations.…”