title: Racial residential segregation and rates of gonorrhea in the United States, 2003-2007.
abstract: OBJECTIVE
  In the United States, Black persons are disproportionately affected by sexually transmitted infections (STIs), including gonorrhea. Individual behaviors do not fully explain these racial disparities. We explored the association of racial residential segregation with gonorrhea rates among Black persons and hypothesized that specific dimensions of segregation would be associated with gonorrhea rates.
  
  
  METHODS
  We used 2003 to 2007 national STI surveillance data and 2000 US Census Bureau data to examine associations of 5 dimensions of racial residential segregation and a composite measure of hypersegregation with gonorrhea rates among Black persons in 257 metropolitan statistical areas, overall and by sex and age. We calculated adjusted rate ratios with generalized estimating equations.
  
  
  RESULTS
  Isolation and unevenness were significantly associated with gonorrhea rates. Centralization was marginally associated with gonorrhea. Isolation was more strongly associated with gonorrhea among the younger age groups. Concentration, clustering, and hypersegregation were not associated with gonorrhea.
  
  
  CONCLUSIONS
  Certain dimensions of segregation are important in understanding STI risk among US Black persons. Interventions to reduce sexual risk may need to account for racial residential segregation to maximize effectiveness and reduce existent racial disparities.
authors.affiliation: Yale School of Public Health and Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA. kbiello@fenwayhealth.org
authors.forename: Katie B
authors.initials: KB
authors.lastname: Biello
authors.forename: Trace
authors.initials: T
authors.lastname: Kershaw
authors.forename: Robert
authors.initials: R
authors.lastname: Nelson
authors.forename: Matthew
authors.initials: M
authors.lastname: Hogben
authors.forename: Jeannette
authors.initials: J
authors.lastname: Ickovics
authors.forename: Linda
authors.initials: L
authors.lastname: Niccolai
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011287:Prejudice; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult; D001741:Black or African American