Does education matter? Examining differences in sexually transmitted infections among black and white young adult females in the U.S

Sexually transmitted infections (STIs) are a major public health issue in the U.S. Half of all infections occur among youth/young adults, with minority women suffering disproportionately. Education has been considered a protective factor against STIs; however few have explored differences across racial/ethnic groups. The purpose of this study is to determine if (1) education reduces the risk of STIs; (2) the effect of education on STI risk differs between black and white females.

We use data from Add Health, a nationally representative longitudinal study of adolescents in grades 7-12 in 1994. Measures of STI diagnosis are obtained from the third wave of data collection (2001/2002) when respondents were ages 18-26.

After adjustment for a wide range of sexual and non-sexual behaviors, black females experienced higher odds of STIs compared to white females regardless of educational status. Compared with white females with less than a high school diploma, black females with less than a high school diploma, those with a high school diploma, and those who were enrolled or graduated from college were 2.46 (95% CI: 1.23-3.51), 2.10 (95% CI: 1.26-3.51), and 2.05 (95% CI: 1.09-3.88) times more likely to have an STI, respectively. Furthermore, while increasing education reduced the risk of STIs among white females, we did not find this relationship among black females.

Educational status is not uniformly protective against STIs among this sample of young adult females. Further research should investigate how and why education differentially influences young females' risk of acquiring STIs across racial/ethnic groups.