title: Does education matter? Examining racial differences in the association between education and STI diagnosis among black and white young adult females in the U.S.
abstract: OBJECTIVE
  Education has long been considered a protective factor against sexual risk behaviors and sexually transmitted infections (STIs) among adolescents; however, few have explored this association and determined differences across racial/ethnic groups of young adult females on a national scale. The purpose of this study was to (1) describe the association between education and STI diagnosis among a national sample of black and white young adult females and (2) examine racial differences in this association.
  
  
  METHODS
  We used data from the National Longitudinal Study of Adolescent Health (Add Health) to assess the association between education and chlamydia, gonorrhea, and/or trichomoniasis (self-reported and assay-diagnosed) in 2001-2002 using logistic regression analysis.
  
  
  RESULTS
  After adjustment for risk behaviors, education was inversely associated with any assay-diagnosed STI, but this association was nonsignificant among black women for self-reported STI. Additionally, black females enrolled in, or who graduated from, college had significantly higher predicted probabilities of having an STI (12.4% self-reported; 13.4% assay-diagnosed) compared with white females who had less than a high school diploma (6.4% self-reported; 2.3% assay-diagnosed).
  
  
  CONCLUSIONS
  Educational status was not uniformly protective against STIs for black and white females in this sample. Particularly for young black women, other factors may play a more prominent role in determining STI risk. Social determinants, such as education, should be viewed as important factors associated with STI prevalence, but their differential impact on various racial/ethnic groups should also be considered when addressing the disproportionate rates of STIs in the U.S.
authors.affiliation: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 800 Sumter St., Ste. 216, Columbia, SC 29208, USA. lannang@sc.edu
authors.forename: Lucy
authors.initials: L
authors.lastname: Annang
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Walsemann
authors.forename: Debeshi
authors.initials: D
authors.lastname: Maitra
authors.forename: Jelani C
authors.initials: JC
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D001741:Black or African American; D002690:Chlamydia Infections / Q000208:ethnology*; D004522:Educational Status; D005260:Female; D006069:Gonorrhea / Q000208:ethnology*; D006306:Health Surveys; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D012309:Risk-Taking; D014245:Trichomonas Infections / Q000208:ethnology*; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult