Socioeconomic disparities in sexually transmitted infections among young adults in the United States: examining the interaction between income and race/ethnicity

Sex Transm Dis. 2013 Jul;40(7):575-81. doi: 10.1097/OLQ.0b013e31829529cf.


Background: There is considerable evidence of racial/ethnic patterning of sexually transmitted infection (STI) risk in the United States. There is also evidence that poorer persons are at increased STI risk. Evidence regarding the interaction of race/ethnicity and income is limited, particularly nationally at the individual level.

Methods: We examined the pattern of socioeconomic gradients in STI infection among young people in a nationwide US study and determined how these gradients varied by race/ethnicity. We estimated the cumulative diagnosis prevalence of chlamydia, gonorrhea, or trichomoniasis (via self-report or laboratory confirmation) for young adults (ages, 18-26 years old) Hispanics and non-Hispanic whites, blacks, and others across income quintiles in the Add Health data set. We ran regression models to evaluate these relationships adjusting for individual- and school-level covariates.

Results: Sexually transmitted infection diagnosis was independently associated with both racial/ethnic identity and with low income, although the racial/ethnic disparities were much larger than income-based ones. A negative gradient of STI risk with increasing income was present within all racial/ethnic categories, but was stronger for nonwhites.

Conclusions: Both economic and racial/ethnic factors should be considered in deciding how to target STI prevention efforts in the United States. Particular focus may be warranted for poor, racial/ethnic minority women.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Black People
  • Chlamydia Infections / ethnology*
  • Chlamydia Infections / prevention & control
  • Female
  • Gonorrhea / ethnology*
  • Gonorrhea / prevention & control
  • Health Status Disparities
  • Hispanic or Latino
  • Humans
  • Income
  • Male
  • Poverty
  • Prevalence
  • Regression Analysis
  • Sexually Transmitted Diseases / ethnology*
  • Sexually Transmitted Diseases / prevention & control
  • Socioeconomic Factors
  • Trichomonas Infections / ethnology*
  • Trichomonas Infections / prevention & control
  • United States / epidemiology
  • White People
  • Young Adult