271469 Neighborhood Social Disorganization and Acquisition of Sexually Transmitted Infection: A Life Course Approach

Sunday, October 28, 2012

Jodi Ford, PhD, RN , College of Nursing, The Ohio State University, Columbus, OH
Christopher Browning, PhD , Department of Sociology, Ohio State University, Columbus, OH
Background: Sexually transmitted infections (STIs) remain pervasive among U.S. young adults. Consequently, interest in the role of social contexts in shaping STI outcomes is growing, but few longitudinal studies have been conducted. The purpose of this study was to examine associations between exposure to neighborhood social disorganization during the transition from adolescence to young adulthood and young adults' STI acquisition. Methods: This study employed a longitudinal observational design using secondary data from the National Longitudinal Study of Adolescent Health (AddHealth), waves 1-3 (1994-2002). Neighborhood social disorganization was operationalized as concentrated poverty, residential instability and racial/ethnic heterogeneity. STI outcomes included urinary assay findings for Chlamydia. Multilevel modeling was conducted and focused on the simultaneous contribution of neighborhood exposures during adolescence and young adulthood on STI outcomes. Results: Approximately 6% of young adults had a positive urine test for Chlamydia. Adjusting for numerous individual (e.g. risk behavior) and neighborhood control variables, multilevel findings indicate that exposure to neighborhood concentrated poverty during adolescence was associated with an increased likelihood of a positive urine test for Chlamydia during young adulthood (AOR=1.28, 95% CI=1.11, 1.47) while exposure to neighborhood concentrated poverty during young adulthood had no significant relationship. No significant associations were found between neighborhood racial/ethnic diversity or residential instability during adolescence or young adulthood and young adults' likelihood of having a positive urine test for Chlamydia. Conclusions: Further research is needed to better understand the bio-psychosocial and behavioral pathways through which exposure to neighborhood poverty contributes to acquisition of Chlamydia over the life course.

Learning Areas:
Epidemiology
Social and behavioral sciences

Learning Objectives:
1. Discuss the epidemiology of sexual transmitted infections in adolescents and young adults. 2. Explain how the social determinants of health may contribute to sexually transmitted infections in adolescents and young adults. 3. Discuss the potential bio-psychosocial and behavioral pathways through which neighborhood social disorganization may contribute to sexually transmitted infections in adolescents and young adults.

Keywords: STD, Environment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: My research focuses on the social epidemiology of adolescent and young adult health, particularly the prevention of sexually transmitted infections. I am currently funded by the Robert Wood Johnson Foundation Nurse Faculty Scholar program to investigate the role of neighborhood and school disadvantage to the acquistion of sexually transmitted infections and the mediating bio-psychosocial and behavioral pathways.
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.