title: Socioeconomic-related risk and sexually transmitted infection among African-American adolescent females.
abstract: OBJECTIVE
  Virtually no studies have examined the potential role that chronic stress, particularly the stress associated with socioeconomic status (SES) strain, may play on sexually transmitted infection (STI) risk. This study examined the association between SES-related risk at baseline to STI acquisition and reinfection over 36 months of follow-up.
  
  
  METHODS
  Six hundred twenty-seven African-American female adolescents, ages 14-20 years, recruited from sexual health clinics in Atlanta, GA, participated in a randomized controlled HIV prevention trial and returned for at least one follow-up assessment. Following baseline assessment, six waves of data collection occurred prospectively over 36 months. Chronic SES-related risk was assessed as a sum of yes-no exposure to seven risk indicators. Laboratory-confirmed tests for Chlamydia trachomatis and Neisseria gonorrhoeae were performed at each follow-up.
  
  
  RESULTS
  In multivariable regression analysis, SES-related risk significantly predicted STI acquisition over 36 months (adjusted odds ratio = 1.22) and STI reinfection (adjusted odds ratio = 1.16) above and beyond other known correlates of STI.
  
  
  CONCLUSIONS
  Findings demonstrate that SES-related risk was predictive of both STI acquisition and reinfection among young African-American females. They are consistent with propositions that some health disparities observed in adulthood may be linked to earlier chronically stress-inducing life experiences, particularly experiences associated with low SES conditions. Although various explanations exist for the observed connection between SES-related risk and subsequent STI acquisition and/or reinfection across 36 months of follow-up, these findings highlight the need for further research to elucidate the exact pathway(s) by which SES-related risk influences later STI acquisition to refine STI prevention interventions for this population.
authors: Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia; Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia; Center for Contextual Genetics and Prevention Science, University of Georgia, Athens, Georgia. Electronic address: jmcderm@emory.edu.
authors: Jessica M
authors: JM
authors: Sales
authors: Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia.
authors: Erica L
authors: EL
authors: Smearman
authors: Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia; Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia.
authors: Andrea
authors: A
authors: Swartzendruber
authors: Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia; Department of Psychology, Texas Tech University, Lubbock, Texas.
authors: Jennifer L
authors: JL
authors: Brown
authors: Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia; Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia; Center for Contextual Genetics and Prevention Science, University of Georgia, Athens, Georgia.
authors: Gene
authors: G
authors: Brody
authors: Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, Georgia; Center for AIDS Research, Social and Behavioral Sciences Core, Emory University, Atlanta, Georgia; Center for Contextual Genetics and Prevention Science, University of Georgia, Athens, Georgia.
authors: Ralph J
authors: RJ
authors: DiClemente
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000208:ethnology*; D001741:Black or African American / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005845:Georgia / Q000453:epidemiology; D054624:Health Status Disparities; D006801:Humans; D012309:Risk-Taking; D012725:Sexual Behavior / Q000208:ethnology*; D012749:Sexually Transmitted Diseases / Q000208:ethnology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Adolescents; African-American; Females; SES; STIs; Stress