title: Socioeconomic disparities in sexually transmitted infections among young adults in the United States: examining the interaction between income and race/ethnicity.
abstract: BACKGROUND
  There is considerable evidence of racial/ethnic patterning of sexually transmitted infection (STI) risk in the United States. There is also evidence that poorer persons are at increased STI risk. Evidence regarding the interaction of race/ethnicity and income is limited, particularly nationally at the individual level.
  
  
  METHODS
  We examined the pattern of socioeconomic gradients in STI infection among young people in a nationwide US study and determined how these gradients varied by race/ethnicity. We estimated the cumulative diagnosis prevalence of chlamydia, gonorrhea, or trichomoniasis (via self-report or laboratory confirmation) for young adults (ages, 18-26 years old) Hispanics and non-Hispanic whites, blacks, and others across income quintiles in the Add Health data set. We ran regression models to evaluate these relationships adjusting for individual- and school-level covariates.
  
  
  RESULTS
  Sexually transmitted infection diagnosis was independently associated with both racial/ethnic identity and with low income, although the racial/ethnic disparities were much larger than income-based ones. A negative gradient of STI risk with increasing income was present within all racial/ethnic categories, but was stronger for nonwhites.
  
  
  CONCLUSIONS
  Both economic and racial/ethnic factors should be considered in deciding how to target STI prevention efforts in the United States. Particular focus may be warranted for poor, racial/ethnic minority women.
authors: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA. gharling@hsph.harvard.edu
authors: Guy
authors: G
authors: Harling
authors: Sv
authors: S
authors: Subramanian
authors: Till
authors: T
authors: Bärnighausen
authors: Ichiro
authors: I
authors: Kawachi
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People; D002690:Chlamydia Infections / Q000208:ethnology* / Q000517:prevention & control; D005260:Female; D006069:Gonorrhea / Q000208:ethnology* / Q000517:prevention & control; D054624:Health Status Disparities; D006630:Hispanic or Latino; D006801:Humans; D007182:Income; D008297:Male; D011203:Poverty; D015995:Prevalence; D012044:Regression Analysis; D012749:Sexually Transmitted Diseases / Q000208:ethnology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D014245:Trichomonas Infections / Q000208:ethnology* / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult; D001741:Black or African American
references: Am J Public Health. 2010 Jun;100(6):1060-7
references: 20395580
references: Sex Transm Dis. 2008 Dec;35(12):981-4
references: 18685545
references: Sex Transm Dis. 2005 Oct;32(10):593-8
references: 16205299
references: Ann Intern Med. 2007 Jul 17;147(2):89-96
references: 17638719
references: Public Health Rep. 2010 Jul-Aug;125 Suppl 4:110-21
references: 20629254
references: Sex Transm Dis. 1996 Jan-Feb;23(1):16-23
references: 8801638
references: Am J Public Health. 2004 Nov;94(11):1952-8
references: 15514236
references: AIDS Behav. 2012 Jul;16(5):1092-114
references: 22234436
references: J Womens Health (Larchmt). 2012 Mar;21(3):249-54
references: 22196231
references: Soc Sci Med. 2012 Apr;74(8):1240-50
references: 22386616
references: Am J Public Health. 2009 Nov;99(11):2069-78
references: 19762676
references: Sex Transm Dis. 2004 Sep;31(9):533-41
references: 15480114
references: Public Health Rep. 2003 May-Jun;118(3):240-60
references: 12766219
references: Am J Public Health. 2012 Jul;102(7):1370-7
references: 22594733
references: Sex Transm Dis. 1999 May;26(5):262-4
references: 10333278
references: J Urban Health. 2005 Jun;82(2 Suppl 3):iii26-34
references: 15933328
references: Sex Transm Dis. 2008 Dec;35(12 Suppl):S13-8
references: 18936725
references: Am J Public Health. 2008 Jun;98(6):1128-36
references: 18445794
references: JAMA. 2004 May 12;291(18):2229-36
references: 15138245
references: Ann Epidemiol. 2010 Jul;20(7):532-8
references: 20538196
references: Am J Public Health. 2011 Sep;101(9):1696-703
references: 21778488
references: Am J Public Health. 2005 Feb;95(2):324-30
references: 15671471
references: Am J Public Health. 2007 Jan;97(1):125-32
references: 17138921
references: Am J Public Health. 2009 Nov;99(11):1937-40
references: 19762665
references: Sex Transm Dis. 1999 May;26(5):250-61
references: 10333277
references: J Infect Dis. 2005 Feb 1;191 Suppl 1:S115-22
references: 15627221
references: Sex Transm Infect. 2007 Jul;83(4):257-66
references: 17664359