Neighborhood Environment, Sexual Risk Behaviors and Acquisition of Sexually Transmitted Infections Among Adolescents Diagnosed with Psychological Disorders

Abstract

The association between neighborhood environment and prevalence of STIs, sexual partner variables and condom use among adolescents with psychological disorders was examined. Cross-sectional data in three urban areas of the US (Southeast, Northeast and Midwest) were obtained from 384 sexually active male and female participants who provided urine samples for laboratory-confirmed testing of Neisseria gonorrhoeae, Chlamydia trachomatis and Trichomonas vaginalis. A total of 15.4% of participants tested positive for one of the three STIs. Results indicated that relative to adolescents living in low risk neighborhood environments, those living in high risk environments were significantly more likely to have a STI and to report having casual partners. Findings suggest that in high risk neighborhoods, STI acquisition may be less dependent on condom use and more dependent on other contextual factors. The importance of expanding public health research to include assessment of neighborhood context as a determinant of sexual risk-taking is emphasized.

Neighborhood Condition and Geographic Locale in Assessing HIV/STI Risk Among African American Adolescents

“…Similar to other studies, HIV/STI risk was generally greater among participants living in poorer quality neighborhoods [18,27,41–43]. Adolescents who reported greater neighborhood stress also had greater odds of having an STI.…”

“…Empirically, independently rated neighborhood disorder predicts subjective perceptions of neighborhood quality [25] and neighborhood of residence has been associated with perceptions of neighborhood problems in an area [26]. Other studies have utilized subjective assessments of neighborhood quality as an indicator of neighborhood disorder in exploring sexual health risks [27] and perceived neighborhood quality impacts sexual risks behaviors through direct and indirect pathways [18]. Neighborhood quality was assessed using 10 items from the Neighborhood Stress Index [28].…”

Neighborhood Context and Black Heterosexual Men’s Sexual HIV Risk Behaviors

“…These U.S.-based studies demonstrate relationships between sexual risk behaviors and neighborhood structural dimensions such as neighborhood social disorder (e.g., violence, selling drugs) 9,16 ; neighborhood environment (e.g., vacant or boarded up buildings) 18 ; neighborhood economic disadvantage (e.g., proportion of poverty) 17 ; or social disorganization (e.g., proportions of married couples living with children under age 18) 19 . There is also some evidence, at least for predominantly White educated, employed, middle-class gay men who live in racially diverse neighborhoods, that neighborhood characteristics such as a high proportion of same-sex households may increase sexual risk 22 , although other studies suggest that these neighborhood characteristics protect against sexual risk 21 or cocaine use and substance dependence 22 .…”

Risking it for Love: Romantic Relationships and Early Pubertal Development Confer Risk for Later Disruptive Behavior Disorders in African-American Girls Receiving Psychiatric Care

“…Adolescent girls with DBP are at high risk for other negative health outcomes, including severe and comorbid psychiatric conditions (e.g., suicide, depression) diabetes, HIV/AIDS, miscarriage, and mortality (Hawkins, Chiancone, & Whitworth, 2008). These disparities are particularly pronounced for African American girls from low-income families (Lang et al, 2010) resulting in great cost to public health (Sheehan & Flynn, 2007). Unfortunately, most research on DBP focuses on males and little is known about gender differences in the etiology and pathology of disruptive behaviors, largely because girls are historically underrepresented in research in this area.…”