(SDAR) Evaluation of STI Syndemics in Adolescents and Young Adults
Grantee: Texas A&M University System, The
Principal Investigator: Maria Perez-Patron
Project Number: R40MC30760
Project Date: 4/01/17
Final Report
(SDAR) Evaluation of STI Syndemics in Adolescents and Young Adults Final Report (PDF)
Age group(s)
- Adolescence (12-18 years)
- Young Adulthood (19-25 years)
Abstract
There is an epidemic of sexually transmitted infections (STIs), affecting an estimated one in four American adolescent girls, and rates are highest among racial and ethnic minority women. The higher rates of STIs among Black and Hispanic youth facilitate HIV infection, so that the population-attributable risk of STIs for sexual transmission of HIV among Black and Hispanic youth is considerable. We aim to test for STI syndemics in youth and young adults. This framework recognizes that interacting physical, mental and social problems contribute to health disparities, and that social disadvantage at the personal level intersects with inequalities and barriers on the social level. In syndemic theory, interaction between individual-level factors (such as race, early substance use, and depression) and community-level factors (such as neighborhood racial/ethnic composition, disadvantage, urban/rural) must be tested. Additional research is needed to test for syndemics in youth and young adults from a wider variety of backgrounds to better understand how substance use, mental illness and disadvantage interact to perpetuate health disparities in STIs in different groups. This project is unique because it is an inter-disciplinary collaboration among an epidemiologist (PI), developmental psychologist (Co-I), and demographer (Co-I) with insights from lifespan psychology, reproductive epidemiology, and population health to provide novel information about the syndemics of STIs. An innovative feature is that we are empirically testing syndemics by appropriately analyzing recent data (2005-2014) from 2 large datasets, the National Health and Nutrition Examination Study (NHANES) and the American Community Survey (ACS). Recent biological and behavioral data (2005-2012) on 14-25 year olds in the National Health and Nutrition Examination Study (NHANES) will be combined with community-level data from the ACS. These data will be used to test for syndemics between substance use, mental health, neighborhood context and biologically confirmed STIs (aim 1). In addition, we will determine if syndemic relationships vary by gender and race/ethnicity (aim 2). These analyses will address important conceptual and methodological gaps in the literature by providing empirical evidence for syndemics in the general population, including heterosexual women of color who are disproportionately affected by STIs. These results will guide future prospective studies that can more closely examine longitudinal pathways promoting health disparities in STIs, and help inform providers about the best targets and the ideal timing for preventative interventions integrating multiple levels of risk to prevent STIs in men and women from different ethnic/racial groups. Thus, this study will address a number of MCHB strategic research issues including: Strategic Research Issue #II (better understand health disparities in STIs among youth and young adults through syndemic theory) and Strategic Research Issue #IV (Understand syndemic factors that influence STI acquisition in youth and young adults to improve prevention programs). We expect that our long-term research goals will impact priority areas including adolescent preventive services. As STIs impact future reproductive health, our work will also impact preconception health. An increased understanding of STI syndemics can identify targets (i.e. social factors that interact with environment) for effective interventions.Publications
Listed is descending order by year published.
Hill AV, De Genna NM, Perez-Patron MJ, Gilreath TD, Tekwe C, Taylor BD. Identifying Syndemics for Sexually Transmitted Infections Among Young Adults in the United States: A Latent Class Analysis. J Adolesc Health. 2019 Mar;64(3):319-326.
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