title: Examining racial disparities in HIV: lessons from sexually transmitted infections research.
abstract: Racial differences in the prevalence and incidence of HIV infection and AIDS diagnoses in the United States are striking. These differences have been recognized for nearly 20 years, yet they are not well investigated. In this article, we examine 15 factors identified in the sexually transmitted infection (STI) literature to explain the presence of racial/ethnic disparities in STIs. We review findings from these studies and offer suggestions for future research, with the goal of further understanding and reducing disparities in HIV. In general, the STI literature shows that an evaluation of individual behavior is necessary but insufficient on its own to account for racial/ethnic disparities in STIs. Population parameters should be included within models that traditionally include individual-level factors. The 15 factors can be categorized into 3 broad overarching themes: behavioral, prevention participation, and biologic explanations of differentials in STI transmission and infection. Future research that focuses on only 1 of the 15 factors discussed in this review, to the exclusion of others, is likely to yield poor outcomes. Conversely, an emphasis on the interactions of several factors is more likely to produce effective public health interventions and reductions in HIV transmission.
authors.affiliation: HIV/AIDS Prevention Research Division, Department of Psychiatry, School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. julie6@mail.med.upenn.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Kraut-Becher
authors.forename: Marlene
authors.initials: M
authors.lastname: Eisenberg
authors.forename: Chelsea
authors.initials: C
authors.lastname: Voytek
authors.forename: Tiffany
authors.initials: T
authors.lastname: Brown
authors.forename: David S
authors.initials: DS
authors.lastname: Metzger
authors.forename: Sevgi
authors.initials: S
authors.lastname: Aral
mesh_terms: D001685:Biological Factors; D005006:Ethnicity / Q000523:psychology*; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D015438:Health Behavior / Q000208:ethnology*; D006801:Humans; D010349:Patient Compliance / Q000208:ethnology*; D014481:United States / Q000453:epidemiology
chemical_list: D001685:Biological Factors