title: Are social organizational factors independently associated with a current bacterial sexually transmitted infection among urban adolescents and young adults?
abstract: This study explored the relationship between the social organization of neighborhoods including informal social control and social cohesion and a current bacterial sexually transmitted infection (STI) among adolescents and young adults in one U.S. urban setting. Data for the current study were collected from April 2004 to April 2007 in a cross-sectional household study. The target population included English-speaking, sexually-active persons between the ages of 15 and 24 years who resided in 486 neighborhoods. The study sample included 599 participants from 63 neighborhoods. A current bacterial STI was defined as diagnosis of a chlamydia and/or gonorrhea infection at the time of study participation. Participants reported on informal social control (i.e. scale comprised of 9 items) and social cohesion (i.e. scale comprised of 5 items) in their neighborhood. In a series of weighted multilevel logistic regression models stratified by gender, greater informal social control was significantly associated with a decreased odds of a current bacterial STI among females (AOR 0.53, 95% CI 0.34, 0.84) after controlling for individual social support and other factors. The association, while in a similar direction, was not significant for males (AOR 0.73, 95% CI 0.48, 1.12). Social cohesion was not significantly associated with a current bacterial STI among females (OR 0.85, 95% CI 0.61, 1.19) and separately, males (OR 0.98, 95% CI 0.67, 1.44). Greater individual social support was associated with an almost seven-fold increase in the odds of a bacterial STI among males (AOR 6.85, 95% CI 1.99, 23.53), a finding which is in contrast to our hypotheses. The findings suggest that neighborhood social organizational factors such as informal social control have an independent relationship with sexual health among U.S. urban youth. The causality of the relationship remains to be determined.
authors.affiliation: Center for Child and Community Health Research (CCHR), Department of Pediatrics, School of Medicine, Johns Hopkins University, Bayview Medical Center, 5200 Eastern Ave, Mason F Lord Building, Center Tower Ste 4200, Baltimore, MD 21224, USA; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA. Electronic address: jjennin1@jhmi.edu.
authors.forename: Jacky M
authors.initials: JM
authors.lastname: Jennings
authors.affiliation: Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, 410 W. 10th Street Room 10001, Indianapolis, IN 46202, USA; Department of Sociology, Indiana University Purdue University Indianapolis, 425 University Blvd, Indianapolis, IN 46202, USA.
authors.forename: Devon J
authors.initials: DJ
authors.lastname: Hensel
authors.affiliation: Department of Public Health Education, University of North Carolina Greensboro, PO Box 26170, Greensboro, NC 27402, USA.
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Tanner
authors.affiliation: Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, 624 North Broadway, Baltimore, MD 21205 USA.
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Reilly
authors.affiliation: Center for Child and Community Health Research (CCHR), Department of Pediatrics, School of Medicine, Johns Hopkins University, Bayview Medical Center, 5200 Eastern Ave, Mason F Lord Building, Center Tower Ste 4200, Baltimore, MD 21224, USA; Department of Pediatrics, School of Medicine, Johns Hopkins University, All Children's Hospital Johns Hopkins Medicine, Office of the President, 501 6th Avenue South, Box 9530, St. Petersburg, FL 33701, USA.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Ellen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D000367:Age Factors; D002690:Chlamydia Infections / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior / Q000523:psychology*; D015231:Sexually Transmitted Diseases, Bacterial / Q000453:epidemiology*; D066270:Social Capital; D012927:Social Control, Informal; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Adolescents; Infectious disease; Informal social control; Sexually transmitted infections; Social capital; Social epidemiology
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