Sexually Transmitted Infection Disparities and Social Determinants of Health in California, 2013‒2021

Am J Public Health. 2025 May;115(5):799-807. doi: 10.2105/AJPH.2024.307963. Epub 2025 Mar 6.

Abstract

Objectives. To characterize the intersection of social determinants of health, measured as the availability of community opportunities for healthy living, and sexually transmitted infections (STIs) in California. Methods. Geocoded 2013-2021 California bacterial STI cases were aggregated into Healthy Places Index (HPI) quartiles. Communities in the lowest scoring HPI quartile have the fewest opportunities for healthy living, while communities in the highest scoring quartile have the most opportunities. Results. As community opportunities became more available, bacterial STI risk decreased. Asian people had the lowest bacterial STI rates, while Black/African American people had the highest. As community opportunities increased, White people had the largest overall STI risk reduction, Native Hawaiian and other Pacific Islander people had the smallest reduction, Hispanic/Latino people had equivalent gonorrhea and early syphilis risk, and American Indian/Alaska Native people had equivalent chlamydia risk. Conclusions. Although STI incidence decreased as community opportunities increased, people of different racial and ethnic identities were differentially affected. Because the availability of community opportunities is not enough to mitigate racial health disparities, more work is needed to ensure community-level STI prevention efforts are accessible and inclusive. (Am J Public Health. 2025;115(5):799-807. https://doi.org/10.2105/AJPH.2024.307963).

MeSH terms

  • Adult
  • California / epidemiology
  • Ethnicity / statistics & numerical data
  • Female
  • Health Status Disparities*
  • Humans
  • Male
  • Sexually Transmitted Diseases* / epidemiology
  • Sexually Transmitted Diseases* / ethnology
  • Social Determinants of Health* / statistics & numerical data