The racial disparities in STI in the U.S.: Concurrency, STI prevalence, and heterogeneity in partner selection

Hamilton, Deven T.; Morris, Martina

doi:10.1016/j.epidem.2015.02.003

Cited by 53 publications

(43 citation statements)

References 43 publications

(41 reference statements)

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“…1,2 For example, assortative mixing by ethnicity is believed to contribute to the high STI prevalence in African Americans in the US, which cannot be fully explained by individual-level sexual behaviors. 3,4 Conversely, disassortative mixing may lead to a more generalized spread of infection between populations and larger epidemics. 1,2 …”

Section: Introductionmentioning

confidence: 99%

Assortativity and Mixing by Sexual Behaviors and Sociodemographic Characteristics in Young Adult Heterosexual Dating Partnerships

Malagón¹,

Burchell²,

El‐Zein³

et al. 2017

Sexual Trans Dis

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Background Assortative sexual mixing, the tendency for individuals to choose partners with similar characteristics to themselves, may be an important contributor to the unequal distribution of sexually transmitted infections in populations. We analyzed the tendency for assortative mixing on demographic and sexual behaviors characteristics in newly formed young adults dating partnerships. Methods Women aged 18–24 and their male sexual partners of no more than 6 months were recruited during 2005–2010 at universities in Montreal, Canada. New dating partners were also prospectively recruited during the two-year follow-up. We used Spearman and Newman coefficients to examine correlations between partners’ demographic characteristics and sexual behaviors, and multivariable logistic modeling to determine which characteristics were assortative. Results Participants in 502 recruited partnerships were assortative on age (Spearman ρ=0.60), smoking behavior (ρ=0.43), ethnicity (Newman coefficient=0.39), lifetime number of sexual partners (ρ=0.36), sex partner acquisition rates (ρ=0.22), gap length between partnerships (ρ=0.20), and on whether they had concurrent partners (ρ=0.33). Partners were assortative on number of lifetime partners, sexual partner acquisition rates, concurrency, and gap length between partnerships even after adjustment for demographic characteristics. Reported condom use was correlated between initial and subsequently recruited partners (ρ=0.35). There was little correlation between the frequencies of vaginal/oral/digital/anal sex between subsequent partnerships. Conclusions Dating partnerships were substantially assortative on various sexual behaviors as well as demographic characteristics. Though not a representative population sample, our recruitment of relatively new partnerships reduces survivor bias inherent to cross-sectional surveys where stable long-term partnerships are more likely to be sampled.

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Section: Introductionmentioning

confidence: 99%

Assortativity and Mixing by Sexual Behaviors and Sociodemographic Characteristics in Young Adult Heterosexual Dating Partnerships

Malagón¹,

Burchell²,

El‐Zein³

et al. 2017

Sexual Trans Dis

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“…Black young people are at a much higher risk of acquiring a sexually transmitted infection (STI) than their white peers (CDC 2014), partly because of higher rates of concurrency and more assortative mating than other racial groups (Hamilton and Morris 2015; Laumann and Youm 1999). The higher rate of STIs among black young men and women (CDC 2014; Owusu-Edusei et al 2013), coupled with gender distrust among low-income black women (Edin and Kefalas 2005; Whitehead 1997), may result in a greater use of condoms, which protect against STIs but are a less effective method of pregnancy prevention.…”

Section: Introductionmentioning

confidence: 99%

Black-White Differences in Sex and Contraceptive Use Among Young Women

et al. 2016

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This study examines black-white and other sociodemographic differences in young women’s sexual and contraceptive behaviors, using new longitudinal data from a weekly journal-based study of 1,003 18- to 19-year-old women spanning 2.5 years. We investigate hypotheses about dynamic processes in these behaviors during early adulthood in order to shed light on persisting racial differences in rates of unintended pregnancies in the United States. We find that net of other sociodemographic characteristics and adolescent experiences with sex and pregnancy, black women spent less time in relationships and had sex less frequently in their relationships than white women, but did not differ in the number of relationships they formed or in their frequency or consistency of contraceptive use within relationships. Black women were more likely to use less effective methods for pregnancy prevention (e.g., condoms) than white women, who tended to use more effective methods (e.g., oral contraceptives). And although the most effective method for pregnancy prevention—long-acting reversible contraception (LARC)—was used more often by black women than white women, LARC use was low in both groups. In addition, black women did not differ from white women in their number of discontinuations or different methods used and had fewer contraceptive method switches. Further, we find that net of race and adolescent experiences with sex and pregnancy, women from more-disadvantaged backgrounds had fewer and longer (and thus potentially more serious) relationships, used contraception less frequently (but not less consistently), and used less effective methods (condoms) than women from more-advantaged backgrounds.

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“…Many sub-Saharan African countries have been experiencing generalized epidemics of HIV where new infections are no longer primarily the result of partnerships between people with high sexual activity levels and people with lower activity levels, and so the core group is no longer the driving force behind the epidemic. Consequently, a number of studies have considered attribute-based mixing (e.g., race, age, education, disease status) [Hyman and Stanley (1988), Busenberg and Castillo-Chavez (1989), Morris (1991Morris ( , 1994Morris ( , 1995, Aral et al (1999), Morris et al (2009), Morin et al (2014), Hamilton and Morris (2015)]. Morris et al (2009) and Hamilton and Morris (2015) assert that strong assortative mixing by race, coupled with different levels of concurrency, is a plausible explanation for the disparities we observe in HIV (and other STI) prevalence across different races in the United States.…”

Section: Selective Mixingmentioning

confidence: 99%

“…Consequently, a number of studies have considered attribute-based mixing (e.g., race, age, education, disease status) [Hyman and Stanley (1988), Busenberg and Castillo-Chavez (1989), Morris (1991Morris ( , 1994Morris ( , 1995, Aral et al (1999), Morris et al (2009), Morin et al (2014), Hamilton and Morris (2015)]. Morris et al (2009) and Hamilton and Morris (2015) assert that strong assortative mixing by race, coupled with different levels of concurrency, is a plausible explanation for the disparities we observe in HIV (and other STI) prevalence across different races in the United States. If we consider sub-Saharan Africa, few sexual partnerships occurring between individuals from different countries would allow for different rates of HIV spread within individual countries, possibly partially explaining the heterogeneity in HIV prevalence we observe.…”

Section: Selective Mixingmentioning

confidence: 99%

“…Concurrency. Where selective mixing relates to connectivity of subpopulations and disease transmission between subpopulations, concurrency relates to connectivity of individuals and disease spread between individuals, and a number of studies have claimed that concurrency is important in explaining disparities in STI prevalence and the speed with which STIs propagate through a population [Watts and May (1992), Hudson (1993), Morris and Kretzschmar (1995, Kretzschmar and Morris (1996), Ghani, Swinton and Garnett (1997), Chick, Adams and Koopman (2000), Ghani and Garnett (2000), Koopman et al (2000), Schoenbach (2002, 2005), Doherty (2006, 2007), Doherty et al (2006), Morris, Goodreau and Moody (2007), Morris et al (2009), Johnson et al (2009), Mah and Halperin (2010, Eaton, Hallett and Garnett (2011), Goodreau (2011), Goodreau et al (2012, Kretzschmar and Caraël (2012), Hamilton and Morris (2015)]. If we consider a population under serial monogamy, current relationships must end before infected individuals place other noninfected individuals at risk.…”

Section: Selective Mixingmentioning

confidence: 99%

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Modeling concurrency and selective mixing in heterosexual partnership networks with applications to sexually transmitted diseases

Admiraal¹,

Handcock²

2016

Ann. Appl. Stat.

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Network-based models for sexually transmitted disease transmission rely on initial partnership networks incorporating structures that may be related to risk of infection. In particular, initial networks should reflect the level of concurrency and attribute-based selective mixing observed in the population of interest. We consider momentary degree distributions as measures of concurrency and propensities for people of certain types to form partnerships with each other as a measure of attribute-based selective mixing. Estimation of momentary degree distributions and mixing patterns typically relies on cross-sectional survey data, and, in the context of heterosexual networks, we describe how this results in two sets of reports that need not be consistent with each other. The reported momentary degree distributions and mixing totals are related through a series of constraints, however. We provide a method to incorporate those in jointly estimating momentary degree distributions and mixing totals. We develop a method to simulate heterosexual networks consistent with these momentary degree distributions and mixing totals, applying it to data obtained from the National Longitudinal Study of Adolescent Health. We first use the momentary degree distributions and mixing totals as mean value parameters to estimate the natural parameters for an exponential-family random graph model and then use a Markov chain Monte Carlo algorithm to simulate person-level heterosexual partnership networks.

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The racial disparities in STI in the U.S.: Concurrency, STI prevalence, and heterogeneity in partner selection

Cited by 53 publications

References 43 publications

Assortativity and Mixing by Sexual Behaviors and Sociodemographic Characteristics in Young Adult Heterosexual Dating Partnerships

Assortativity and Mixing by Sexual Behaviors and Sociodemographic Characteristics in Young Adult Heterosexual Dating Partnerships

Black-White Differences in Sex and Contraceptive Use Among Young Women

Modeling concurrency and selective mixing in heterosexual partnership networks with applications to sexually transmitted diseases

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