Racial/Ethnic Group Differences in the Prevalence of Sexually Transmitted Diseases in the United States: A Network Explanation

Abstract

African Americans' higher infection rate for bacterial diseases can be explained by the patterns of sexual networks within and between different racial/ethnic groups. First, infections are more widespread in the African American population at large because partner choice is more highly dissortative--meaning that "peripheral" African Americans (who have had only one partner in the past year) are five times more likely to choose "core' African Americans (who have had four or more partners in the past year) than "peripheral" whites are to choose "core" whites. Secondly, sexually transmitted infections stay within the African American population because their partner choices are more segregated (assortative mating) than other groups. The likelihood of African Americans having a sexually transmitted infection is 1.3 times greater than it is for whites because of this factor alone.

Sexual Mixing Patterns and Partner Characteristics of Black MSM in Massachusetts at Increased Risk for HIV Infection and Transmission

“…10,12,16,17 Recent studies have underscored the importance of focusing on and understanding sexual networks by race and prior research has observed a significant tendency among Black MSM to have more partners of the same race. 13,22,24 Consistent with previous studies, 13,22,24 Black MSM in the current sample had more partners who were Black men (49%) and fewer Hispanic/Latino (40%) or White (13%) male partners. However, in contrast with prior research, relative to participants who had sex last with a White male, participants who had sex last with a Hispanic/Latino male were more likely to have engaged in UAS and those who had sex with a Black male were less likely to report engaging in UAS.…”

“…10,12,16,17 Prior research has shown that sexual mixing between members of different populations may facilitate the spread of HIV and STDs. [18][19][20][21][22] Early research with MSM found sexual relationships between MSM of different age groups to be associated with higher risk for HIV infections. 20,21 Studies have more recently begun to underscore the importance of focusing on and understanding racial dynamics in sexual networks.…”

“…13,[22][23][24] For example, Laumann and Youm demonstrated that the incidence and prevalence of HIV and STDs remained higher within Black populations because Black men and women were more likely than White and Latino men and women to have sex exclusively with partners of the same race who were more likely to be HIV-and/or STD-infected. 22 In more recent research focused on MSM, Bingham and colleagues found that racial differences in male partner types partially accounted for elevated rates of HIV infection by examining the role of partner characteristics among 400 MSM ages 23 to 29 in the Los Angeles Young Men's Survey. 13 Approximately 27% of Black MSM reported having a Black male sex partner in the past 12 months compared to 12% of Hispanic/Latinos and 3% of Whites.…”

Assortative mixing as a source of bias in epidemiological studies of sexually transmitted infections: the case of smoking and human papillomavirus

“…Americans have higher STI prevalence after adjustment for sexual activity (7,35). It has been shown that sexual mixing is assortative according to race/ethnicity (7,20) …”

“…We term one particular form of confounding bias the "assortativity bias", because it stems from assortativity in sexual mixing (partner choice). That is, on average, people have partners with similar characteristics (e.g., age) and behavior (e.g., smoking status) as themselves (5)(6)(7)(8).…”