ArticleSexually transmitted diseases2018
Neighborhood Health Care Access and Sexually Transmitted Infections Among Women in the Southern United States: A Cross-Sectional Multilevel Analysis.
Article in Sexually transmitted diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Psychosocial correlates of condom use among Black adolescents in the United States: A meta-analysis.Health psychology : official journal of the Division of Health Psychology, American Psychological Association · 2026Pooled it
- A systematic review of the association between history of sexually transmitted infections and subsequent condom use in adolescents.BMC public health · 2024Pooled it
- Article
- Health literacy and syphilis knowledge: findings from a national survey of U.S. women of reproductive age.BMC public health · 2025Article
- Treatment of Chlamydia and Gonorrhea in Primary Care and Its Patient-Level Variation: An American Family Cohort Study.Annals of family medicine · 2025Article
- Etiology of sexually transmitted infections among people living with HIV (PLWHIV) within meme division in Cameroon: seroprevalence and factors associated with transmission.Frontiers in public health · 2025Article
- Prevalence and Genetic Characterization ofThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2025Article
- Relationship Between Sexually Transmitted Infections and Social Determinants of Health in Durham County, North Carolina, United States.Open forum infectious diseases · 2023Article
- Social Determinants of Sexual Behavior and Awareness of Sexually Transmitted Infections (STI) Among Low-Income HIV+ or STI At-Risk Hispanic Residents Receiving Care at the U.S.-Mexico Border.Journal of community health · 2019Article
- The Black-White Disparity in Sexually Transmitted Diseases During Pregnancy: How Do Racial Segregation and Income Inequality Matter?Sexually transmitted diseases · 2018Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
introductionThe United States has experienced an increase in reportable sexually transmitted infections (STIs) while simultaneously experiencing a decline in safety net services for STI testing and treatment. This multilevel study assessed relationships between neighborhood-level access to health care and STIs among a predominantly Human Immunodeficiency Virus (HIV)-seropositive cohort of women living in the south.
methodsThis cross-sectional multilevel analysis included baseline data from HIV-seropositive and HIV-seronegative women enrolled in the Women's Interagency HIV Study sites in Alabama, Florida, Georgia, Mississippi, and North Carolina between 2013 and 2015 (N = 666). Administrative data (eg, United States Census) described health care access (eg, percentage of residents with a primary care provider, percentage of residents with health insurance) in the census tracts where women lived. Sexually transmitted infections (chlamydia, gonorrhea, trichomoniasis, or early syphilis) were diagnosed using laboratory testing. Generalized estimating equations were used to determine relationships between tract-level characteristics and STIs. Analyses were conducted using SAS 9.4.
resultsSeventy percent of participants were HIV-seropositive. Eleven percent of participants had an STI. A 4-unit increase in the percentage of residents with a primary care provider was associated with 39% lower STI risk (risk ratio, 0.61, 95% confidence interval, 0.38-0.99). The percentage of tract residents with health insurance was not associated with STIs (risk ratio, 0.98, 95% confidence interval, 0.91-1.05). Relationships did not vary by HIV status.
conclusionsGreater neighborhood health care access was associated with fewer STIs. Research should establish the causality of this relationship and pathways through which neighborhood health care access influences STIs. Structural interventions and programs increasing linkage to care may reduce STIs.
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