Multiple diseases, multiple causes of sexually transmitted infections

Sexually transmitted infections, or STIs, are a major public health issue that disproportionately affects adolescents, young adults and minorities. To improve prevention efforts, Texas A&M public health researchers will study the impact of various social, demographic and neighborhood-level factors on STI disparities. This research is funded by a grant from the Health Resources and Services Administration of the U.S. Department of Health and Human Services.

STIs are a significant health problem for young people and carry increased risks of adverse outcomes like acquisition of HIV infection and infertility later in adulthood, and the Centers for Disease Control and Prevention (CDC) recently stated that reported STIs are at an unprecedented high in the United States.

“Previous preventive campaigns have focused on individual risk behaviors, but STIs appear to be a ‘syndemic’—in other words, a synergistic epidemic, an issue that involves many diseases, causes and mitigating factors connected through multiple feedback mechanisms,” said Brandie DePaoli Taylor, PhD, assistant professor in the Epidemiology and Biostatistics Department at the Texas A&M School of Public Health and one of the study’s principal investigators. “This could explain the notable inequalities in STI rates seen among young people from different races, ethnicities and social backgrounds.”

In this study, Taylor and her co-investigators Maria Perez-Patron, PhD, research assistant professor at the Texas A&M School of Public Health, along with Natacha DeGenna, PhD, of the University of Pittsburgh, will analyze restricted data from two large national datasets: the National Health and Nutrition Examination Study (NHANES) and the American Community Survey (ACS). Research will be conducted at the Texas Research Data Center, which is based at Texas A&M University.

NHANES is an extensive dataset containing interview results and data from physical exams and laboratory work for a broad swath of Americans. Taylor’s team will use restricted NHANES data for nearly 8,500 people ranging from 14 to 25 years of age. They will merge NHANES data with census tract data from ACS, an ongoing survey by the U.S. Census Bureau.

With these extensive population-based data, researchers will be able to better understand STI disparities, specifically looking at herpes simplex virus (HSV II), human papilloma virus (HPV) and chlamydia, and the complex interaction that factors like gender, race and ethnicity, substance use, mental illness and neighborhood-level factors have with STIs. This would be a major improvement over most existing studies that either used small sample sizes, examined only individual risk behaviors, excluded neighborhood-level data or lacked generalizability due to a limited focus on one disease or specific high-risk locations. Preliminary studies Taylor and colleagues conducted using publicly available NHANES data on HSV II found a possible syndemic relationship with drug use, depression, poverty, race and gender.

“The results of this study will serve as a guide for future research on STI disparities,” Taylor said. “In addition, the conclusions we glean from our analysis will help health care professionals and public health experts form more effective prevention measures.”

This project is supported by a grant from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number R40MC30760-01-00 and title Maternal And Child Health Field-Initiated Research Program. This information or content and conclusions are those of the authors and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.