226903 Travel time to health care provider is associated with testing positive for Gonorrhea, Chlamydia, or Trichomonas in a sample of public housing residents

Tuesday, November 9, 2010 : 1:30 PM - 1:50 PM

Loida Bonney, MD, MPH , Division of General Medicine, Emory University School of Medicine, Atlanta, GA
Hannah LF Cooper, ScD, SM , Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA
Josalin Hunter-Jones, MSW, MPH , Department of Behavioral Sciences and Health Education, Rollins School of Public Health at Emory University, Atlanta, GA
Background: High STI rates have been explained by sexual behavior, sexual networks, and rates of incarceration among other factors, and are greater in areas of high poverty and drug use. In addition, spatial access to healthcare may affect how rapidly STIs are treated and likelihood of spread. The current analysis evaluates the relationship between travel time to health care provider and likelihood of testing positive for one of three STIs in a sample of public housing residents from 5 neighborhoods. Methods: One hundred and three subjects recruited to participate in a study of housing relocation and HIV risk completed a computer assisted personal interview. STI-positives had urine PCR positive for N. gonorrhea, C. trachomatis, or T. vaginalis. Travel time was a continuous variable of number of minutes it took to reach the place where they got most of their care. Analyses used generalized estimating equations to address neighborhood clustering. The multivariate model controlled for sociodemographic characteristics, STI history, and sexual behavior. Travel time was squared to linearize relationship. Results: Thirty six residents tested positive for one or more STI. A non-linear relationship existed between travel time and STI status. When travel time was <43 minutes, a positive relationship existed between travel time and the odds of testing positive for an STI, though the magnitude of this relationship declined as travel time rose. An inverse relationship existed when travel time was >43 minutes. Conclusion: Residents of impoverished communities experience improved sexual health if healthcare services require less travel time to reach.

Learning Areas:
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public

Learning Objectives:
1. Explain how travel time to Health Care services is associated with likelihood of testing positive for one or more of three sexually transmitted diseases.

Keywords: STD, Public Housing

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an abstract author because I am a Principal investigator on this study, and am a physician who cares for patients with HIV/AIDS and STIs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.