Details:

Alternative Title:
Sex Transm Dis
Personal Author:
Haley, Danielle F. ; Edmonds, Andrew ; Belenky, Nadya ; Hickson, DeMarc A. ; Ramirez, Catalina ; ... More +
Haley, Danielle F. ; Edmonds, Andrew ; Belenky, Nadya ; Hickson, DeMarc A. ; Ramirez, Catalina ; Wingood, Gina M. ; Bolivar, Hector ; Golub, Elizabeth ; Adimora, Adaora A. ; Less -
Description:
Introduction The United States (US) has experienced an increase in reportable sexually transmitted infections (STIs) while simultaneously experiencing a decline in safety net services for STI testing and treatment. This multilevel study assessed relationships between neighborhood-level access to health care and STIs among a predominantly HIV-seropositive cohort of women living in the South. Methods This cross-sectional multilevel analysis included baseline data from HIV-seropositive and HIV-seronegative women enrolled in the Women’s Interagency HIV Study sites in Alabama, Florida, Georgia, Mississippi, and North Carolina between 2013 and 2015 (N=666). Administrative data (e.g., US Census) described health care access (e.g., percentage of residents with a primary care provider, percentage of residents with health insurance) in the census tracts where women lived. STIs (chlamydia, gonorrhea, trichomoniasis, or early syphilis) were diagnosed using laboratory testing. Generalized estimating equations were used to determine relationships between tract-level characteristics and STIs. Analyses were conducted using SAS 9.4. Results Seventy percent of participants were HIV-seropositive. Eleven percent of participants had an STI. A four-unit increase in the percentage of residents with a primary care provider was associated with 39% lower STI risk (RR=0.61, 95% CI=0.38–0.99). The percentage of tract residents with health insurance was not associated with STIs (RR=0.98, 95% CI=0.91–1.05). Relationships did not vary by HIV status. Conclusions Greater neighborhood health care access was associated with fewer STIs. Research should establish the causality of this relationship and pathways through which neighborhood health care access influences STIs. Structural interventions and programs increasing linkage to care may reduce STIs.
Subject:
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Adult
Cross-Sectional Studies
Educational Status
Ethnicity
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Humans
Middle Aged
Multilevel Analysis
Patient Acceptance Of Health Care
Residence Characteristics
Sexual Behavior
Sexually Transmitted Diseases
Women's Health
Young Adult

Source:
Sex Transm Dis. 45(1):19-24
Pubmed ID:
28876296
Pubmed Central ID:
PMC5726943
Document Type:
Journal Article ;
Funding:
U01 AI103397/AI/NIAID NIH HHS/United States ; U01 PS003315/PS/NCHHSTP CDC HHS/United States ; UL1 TR000454/TR/NCATS NIH HHS/United States ; U01 AI103401/AI/NIAID NIH HHS/United States ; U01 AI103390/AI/NIAID NIH HHS/United States ; ... More +
U01 AI103397/AI/NIAID NIH HHS/United States ; U01 PS003315/PS/NCHHSTP CDC HHS/United States ; UL1 TR000454/TR/NCATS NIH HHS/United States ; U01 AI103401/AI/NIAID NIH HHS/United States ; U01 AI103390/AI/NIAID NIH HHS/United States ; U01 AI103408/AI/NIAID NIH HHS/United States ; P30 AI050410/AI/NIAID NIH HHS/United States ; U01 AI042590/AI/NIAID NIH HHS/United States ; Less -
Place as Subject:
Southwestern United States ;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:27fa270e3987e5ee93b2b54f0b99ed863f1490a443c4127d0ef115a48223b8f7
File Type:

Supporting Files

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