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Association Between Economic Status and Sexually Transmitted Diseases

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Association Between Economic Status and Sexually Transmitted Diseases

Abstract

Studies conducted over the years indicate that individuals from low economic backgrounds have the highest risk of acquiring sexually transmitted infections. Other researchers have shown that the risk of acquiring STI is influenced by race and ethnicity rather that economic status, making it necessary to review the available literature to determine whether any association exists between an individual’s economic status and their risk of acquiring STI. Literature on economic status and sexually transmitted infections were reviewed. Several search engines including PubMed Central and EBSCOhost facilitated the study. The primary search terms that were used included “sexually transmitted diseases,” “risk groups,” “income inequality,” “economic status,” “race,” “ethnicity”, and “epidemiology”. The results show that sexually transmitted infection diagnosis is linked to low economic status in addition to racial and ethnic identity. People from poor economic background lack the money needed to access medical healthcare and tend to lack knowledge about sexually transmitted infections, factors that increase their risk of acquiring the diseases. However, it was found that compared to income-based influences, racial and ethnic disparities have more impact on the rates of STI. The findings suggest a need to focus more on providing knowledge and information pertaining to the infections and concentrating more on young people and especially those from minority groups who tend to be economically disadvantaged.

Association Between Economic Status and Sexually Transmitted Diseases

 

Association Between Economic Status and Sexually Transmitted Diseases

Introduction-association Between Economic Status and Sexually Transmitted Diseases

According to Springer, Samuel, and Bolan (2010), socioeconomic disparities that characterize health in the United States play a crucial role in influencing morbidity and mortality patterns in the country. Apart from affecting an individual’s access to Healthcare, the authors note that socioeconomic status is strongly linked to the behavioral pattern that impact health risks as well as outcomes. According to Pérez-Morente, Sánchez-Ocón, Martínez-García, Martín-Salvador, Hueso-Montoro, and García-García (2019), STIs pose a major public health problem given the increasing rates of infection and the complications that come along when these infections are not attended to on time. Pérez-Morente et al. (2019) note that from around 1995, cases of sexually transmitted infections that have been reported annually have been increasing steadily. According to the authors, these diseases are more prevalent among ethnic minorities, homosexuals, and young people. Similar findings have been obtained in the United States where adolescents and particularly females have shown a disproportionate prevalence of STIs. Sales, Smearman, Swartzendruber, Brown, Brody, and DiClemente (2014) report that in the US alone, 25% of females aged between 14 and 19 years are infected with at least one socially transmitted infection. In one race-specific study conducted by these researchers, it was found that nearly 48% of African-American females within the same age group were infected with either gonorrhea or chlamydia.

The results are not surprising given that for many years, research conducted has shown that the risk of developing STI is influenced by race and ethnicity. The highest rates of STIs have always been found among African-Americans. According to Harling Subramanian, Bärnighausen, and Kawachi (2013), the risk of being infected with a sexually transmitted disease is closely associated with economic status and particularly the income level. On the other hand, Sales et al. (2014) suggest that there is a wide range of risk factors linked with the high rate of sexually transmitted infections especially among adolescents in the US. According to them, the majority of these factors are associated with developmental trajectories including both physical and mental health in addition to social behavior. Others are linked to life transitions such as interpersonal stress and substance abuse. Sales et al. (2014) argues that these factors tend to affect adolescence both physically and behaviorally. On the other hand, Pérez-Morente et al. (2019) claim that since the economic crisis, there has been an increase in certain STIs including genital herpes, chlamydia, hepatitis, and AIDS. While giving the example of Greece, Pérez-Morente et al. (2019) note that budget cuts that occurred in the country led to lack of funding for nearly 30% of community prevention programs during the financial crisis period. The development led to an increase in sexually transmitted infections including Human Immunodeficiency Virus (HIV). Other researchers including Holtgrave and Crosby (2003), Owusu-Edusei Chesson, Leichliter, Kent, and Aral (2013), and Ara (2002) have shown that a close association exists between economic status sexually transmitted diseases.

Method-association Between Economic Status and Sexually Transmitted Diseases

To conduct the study, it was necessary to review all the literature on economic status and sexually transmitted infections. Several search engines including PubMed Central and EBSCOhost facilitated the study. Before conducting the research, several primary search terms were identified and used to search for relevant articles and information. The terms included sexually transmitted diseases, risk groups, income inequality, economic status, race and ethnicity, and epidemiology. Each search that was conducted provided millions of results from which ten sources were sampled and selected on the basis of their relevance to the research topic. While some of the articles identified, reviewed, and incorporated in this study were published as late as 2019, others were published as early as 1979.

Results

From the tens sources that were selected, the following results were obtained

During the non-crisis period, the prevalence of sexually transmitted infections in Spain was lower. During the crisis period, higher rates of these infections were recorded. Before the crisis, the highest percentage of positive diagnosis was 56% while negative diagnosis accounted for 44%. During the crisis, the positive and negative diagnoses accounted for 75% and 25% respectively (Pérez-Morente et al., 2018). The differences that were observed between these two periods were statistically significant.

The risk associated with the socioeconomic status of an individual predicts their risk of acquiring sexually transmitted infections (Sales et al., 2014).Holtgrave and Crosby (2003) found a close association between poverty and chlamydia, income inequality and AIDS as well as chlamydia rates. The researchers established that social capital influences all outcome measures of sexually transmitted infections and is a major predictor variable.

Sexually transmitted infection diagnosis is linked to low income in addition to racial and ethnic identity. Compared to income-based influences, racial and ethnic disparities have more impact on the rates of STI. The impact of improved economic status on sexually transmitted infections prevalence is stronger among non-whites compared to whites (Harlin et al., 2013; Springer et al., 2010; Owusu-Edusei, 2002).

Discussion-association Between Economic Status and Sexually Transmitted Diseases

From the study conducted by Pérez-Morente et al. (2019), it is evident that the rate of sexually transmitted infections increased during the crisis period compared to the non-crisis period. From the study conducted by the researchers, it was established that the human papillomavirus (HPV) was the most prevalent STI that was diagnosed over that period. In another study conducted by Holtgrave and Crosby (2003), AIDS and chlamydia were identified as the most prevalent STI in the US. The findings reveal that transmitted infections vary in terms of prevalence and concentration in geography. The study conducted by Sales et al. (2014) reveals the association between economic status and STI rates. After conducting a study on a group of African-American females, the researchers concluded that their economic status was a significant predictor of their STI risk. Their findings are consistent with the results obtained by other researchers that indicate that health disparities that manifest in adulthood both racially and geographically could be caused by early life experiences. For instance, individuals from low economic status can suffer from the significant chronic strain that can increase their biological risk of developing STI.

The association between individuals’ economic status and their risk of STI can be explained from several perspectives. Reasoning in terms of developmental context, the economic status of individuals during their early years may impact their sexual behavior in adolescence or adulthood. This influence happens both directly and indirectly. Directly low economic status has a negative impact on the ability of individuals to access the required resources. People from poor economic background lack the money needed to access medical healthcare. Moreover, they tend to lack knowledge about sexually transmitted infections. This, in turn, increases their risk of developing these diseases. Additionally, the low economic status of people especially during the adolescence period exposes them to adverse life events that can result in adolescent delinquency and depression. Such behavioral pathology can result in increased indulgence in risky sexual behaviors. This way, it is clear that low economic status can contribute to higher-risk of acquiring STI. Indirectly, the poor economic status of adolescents can increase their risk of acquiring infections. young people from such background encounter difficulties in coping with life and some of them can result in risky sexual practices.Association Between Economic Status and Sexually Transmitted Diseases

Ellen, Kohn, Bolan, Shiboski, and Krieger (1995), Morton, Horton, and Baker (1979), and Ravi and Nair (2011) have shown that a close association exists between economic status and the risk of developing sexually transmitted infections. However, other researchers have sought to explain the relationship between acquisition of STI and economic status with respect to race and ethnicity. A significant majority of these researchers including Harlin et al. (2013), Springer et al., (2010), and Owusu-Edusei, 2002) agree that sexually transmitted infection diagnosis is linked to low income in addition to racial and ethnic identity. Compared to income-based influences, racial and ethnic disparities have more impact on the rates of STI. The impact of improved economic status on sexually transmitted infection prevalence has been found to be stronger among non-whites compared to whites. The findings could be explained with respect to spatial concentrations. Studies conducted in the US have shown that STIs are more prevalent in geographic locations where black people are subjected to economic segregation. Such African-American neighborhoods are characterized by high STI prevalence rates. Moreover, they have higher social risk factors that include risky sexual norms and drug use. Combined, these factors are likely to contribute significantly to risky sexual behaviors, thereby increasing the rate of STI.

Conclusion-association Between Economic Status and Sexually Transmitted Diseases

The study conducted indicates that the low economic status of individuals increases their risk of acquiring sexually transmitted infections. However, it is evident that these results should be approached cautiously because of several limitations. For instance, some researchers have found that race and ethnicity have more impact on sexually transmitted infections that exceeds that of economic status. Given that race/ethnicity is a major determinant of a person’s economic status, it is evident that the findings obtained cannot be generalized. Additional study designs should be conducted to quantify the impact of various determining factors such as race and socioeconomic status on the prevalence of STI. However, it is evident that to eradicate the diseases, there is a need for public policies to concentrate on providing knowledge and information pertaining to the infections and focusing more on young people and especially those from minority groups.

 

 

 

 

 

References

Aral, S. O. (2002). Determinants of STD epidemics: Implications for phase appropriate intervention strategies. Sexually Transmitted Infections, 78(suppl 1), i3 i13.https://sti.bmj.com/content/78/suppl_1

Ellen, J. M., Kohn, R. P., Bolan, G., Shiboski, S., & Krieger, N. (1995). Socioeconomic differences in sexually transmitted disease rates among black and white adolescents, San Francisco, 1990 to 1992. American Journal of Public Health, 85(11), 1546-1548. https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.85.11.1546

Harling, G., Subramanian, S. V., Bärnighausen, T., & Kawachi, I. (2013). Socioeconomic disparities in sexually transmitted infections among young adults in the United States: examining the interaction between income and race/ethnicity. Sexually transmitted diseases, 40(7), 575. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752095/

Holtgrave, D. R., & Crosby, R. A. (2003). Social capital, poverty, and income inequality as predictors of gonorrhea, syphilis, chlamydia and AIDS case rates in the United States. Sexually transmitted infections, 79(1), 62-64. https://sti.bmj.com/content/79/1/62

Morton, W. E., Horton, H. B., & Baker, H. W. (1979). Effects of socioeconomic status on incidences of three sexually transmitted diseases. Sexually transmitted diseases, 6(3), 206-210.

Owusu-Edusei Jr, K., Chesson, H. W., Leichliter, J. S., Kent, C. K., & Aral, S. O. (2013). The association between racial disparity in income and reported sexually transmitted infections. American journal of public health, 103(5), 910-916.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698829/

Pérez-Morente, M. Á., Sánchez-Ocón, M. T., Martínez-García, E., Martín-Salvador, A., Hueso-Montoro, C., & García-García, I. (2019). Differences in Sexually Transmitted Infections between the Precrisis Period (2000–2007) and the Crisis Period (2008–2014) in Granada, Spain. Journal of clinical medicine, 8(2), 277. https://www.mdpi.com/2077-0383/8/2/277/pdf

Ravi, R., & Nair, S. B. (2011). Correlates of sexually transmitted infections among women in southern India. The Journal of Family Welfare, 45-54. http://medind.nic.in/jah/t11/i1/jaht11i1p45.pdf

Sales, J. M., Smearman, E. L., Swartzendruber, A., Brown, J. L., Brody, G., & DiClemente, R. J. (2014). Socioeconomic-related risk and sexually transmitted infection among African-American adolescent females. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 55(5), 698–704. doi:10.1016/j.jadohealth.2014.05.005  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209307/

Springer, Y. P., Samuel, M. C., & Bolan, G. (2010). Socioeconomic gradients in sexually transmitted diseases: A geographic information system–based analysis of poverty, race/ethnicity, and gonorrhea rates in California, 2004–2006. American journal of public health, 100(6), 1060-1067. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866613/