Association between the Neighborhoods You Live in and Sexual and Reproductive Health in Baltimore, MD

Background:  Urban neighborhoods in the United States are segregated by wealth; however, heterogeneity of sexual health experiences within neighborhoods is discussed less and also exists. 

Objectives: 1) Describe frequencies of ever sex, early sex, and condom use; 2) test the associations between these outcomes across 5 different Community Statistical Areas (CSAs).

Study: ACASI interviews were conducted amongst a sample of 15-19 year olds from low-income neighborhoods in East Baltimore recruited through respondent-driven sampling.  Multivariable regressions were conducted using SRH outcomes, CSAs as the independent variable and demographic variables as controls.

Results: 80% of youth reported ever having sex.  Of those, 68% had sex before age 15 and 57% reported condom use at last sex.  However, heterogeneity existed across the CSAs in these SRH outcomes.  In one CSA, youth were almost three times as likely to have ever had sex, 7.5 times as likely to have had sex early, and 25% as likely to have used a condom at last sex.  In the other three CSAs, youth were slightly more likely to have ever had sex and slightly less like to have used a condom at last sex.  There was no neighborhood pattern related to early sex. 

Conclusions: There are differences in SRH outcomes even for youth who all live in poor neighborhoods.  This is true across three SRH outcomes and demands that we not group youth who live in vulnerable environments into the same risk categories and that we explore what differentiates these neighborhoods and why.