The racial disparities in STI in the U.S.: Concurrency, STI prevalence, and heterogeneity in partner selection

BACKGROUND: There is a large and persistent racial disparity in STI in the U.S. which has placed non-Hispanic-Blacks at disproportionately high risk. We tested a hypothesis that both individual-level risk factors (partner number, anal sex, condom use) and local-network features (concurrency and assortative mixing by race) combine to account for the association between race and chlamydia status. METHODS: Data from the Longitudinal Survey of Adolescent Health Wave III were used. Chlamydia status was determined using biomarkers. Individual-level risk behaviors were self-reported. Network location variables for concurrency and assortative mixing were imputed using egocentrically sample data on sexual partnerships. RESULTS: After controlling for demographic attributes including age, sex, marital status, education and health care access there remained a strong association between race and chlamydia status (OR = 5.23, 95% CI 3.83-7.15, p .05 for Non-Hispanic Blacks).