title: The racial disparities in STI in the U.S.: Concurrency, STI prevalence, and heterogeneity in partner selection.
abstract: BACKGROUND
  There is a large and persistent racial disparity in STI in the U.S. which has placed non-Hispanic-Blacks at disproportionately high risk. We tested a hypothesis that both individual-level risk factors (partner number, anal sex, condom use) and local-network features (concurrency and assortative mixing by race) combine to account for the association between race and chlamydia status.
  
  
  METHODS
  Data from the Longitudinal Survey of Adolescent Health Wave III were used. Chlamydia status was determined using biomarkers. Individual-level risk behaviors were self-reported. Network location variables for concurrency and assortative mixing were imputed using egocentrically sample data on sexual partnerships.
  
  
  RESULTS
  After controlling for demographic attributes including age, sex, marital status, education and health care access there remained a strong association between race and chlamydia status (OR = 5.23, 95% CI [3.83-7.15], p < .001 for Non-Hispanic Blacks with Non-Hispanic Whites as the reference category). The inclusion of individual-level risk factors did not alter the association between race and chlamydia (OR = 5.23 for Non-Hispanic Blacks). The inclusion of concurrency and assortative mixing by race substantially reduced the association between race and chlamydia status (OR = 1.87, 95% CI [0.89-3.91] p > .05 for Non-Hispanic Blacks).
authors.affiliation: Center for Studies in Demography and Ecology, University of Washington, United States. Electronic address: dth2@u.washington.edu.
authors.forename: Deven T
authors.initials: DT
authors.lastname: Hamilton
authors.affiliation: Department of Statistics, University of Washington, United States; Department of Sociology, University of Washington, United States.
authors.forename: Martina
authors.initials: M
authors.lastname: Morris
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D012307:Risk Factors; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D047568:Unsafe Sex / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Concurrency; Race; Sexual networks