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Cited by 26Adolescent Sexual and Reproductive HealthReproductive tract infections researchHIV, TB, and STIs Epidemiology

Identifying syndemics for sexually transmitted infections among young adults in the United States: a latent class analysis

Hill, Ashley V., De Genna, Natacha M., Perez-Patron, Maria J., Gilreath, Tamika D., Tekwe, Carmen, Taylor, Brandie DePaoli·2019·Journal of Adolescent Health
DOI 10.1016/j.jadohealth.2018.09.006
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Abstract

Purpose Syndemic theory suggests that the convergence of social, environmental, and ecological factors can interact to exacerbate behavioral health problems and are often intensified by social conditions and disparities. This study used latent class analysis (LCA) to determine gender and racial/ethnic specific classes for sexually transmitted infection (STI) risk.Methods LCA included 18 measured socioeconomic, depression, substance use, and sexual behavioral variables from 1,664 young adults ages 18-25 in the NHANES. Models were stratified by gender and then by race/ethnicity. Logistic regression determined associations between latent class membership and testing positive for one or more STIs (Chlamydia trachomatis, HIV or herpes simplex virus-II). For each stratified analysis, classes with the lowest probability of reported risk factors in the LCA were the reference groups.Results Class 3 in females (highest probability of reporting both socioeconomic and behavioral factors) and class 3 in males (majority behavioral factors) had increased odds of STI (females: OR = 2.7, 95% CI 1.6-4.5; males: OR 2.5, 95% CI 1.3-4.6). By race for females, depression (highest in Hispanics), poverty, and less educated households (highest in blacks and Hispanics) were evident in classes associated with STI. Class 1 black males (majority behavioral factors) had a higher odds of STI compared with low risk white males (OR = 16.4 95% CI 3.7-72.0) However, no other associations were observed among males.Conclusions Risk patterns for STI differed by gender and race/ethnicity. Consistent with syndemic theory, effective STI interventions need to address socioeconomic factors and mental health rather than individual behaviors, particularly for minority women.

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  • Of the 24 publications listed on PubMed that use LCA to explore syndemic relationships, the items in a class are either all diseases or health conditions, all social determinants, or a combination of both.

    “Of the 24 publications listed on PubMed that use LCA to explore syndemic relationships, the items in a class are either all diseases or health conditions, all social determinants, or a combination of both [40,[48], [49], [50], [51], [52], [53], [54]].”

    From Recommendations for empirical syndemics analyses: A stepwise methodological guide (2024) · cites this paper as [48]

  • None of the 24 studies using LCA to identify classes of syndemic determinants tested the nature of the interaction between these factors to determine synergy as opposed to comorbidity.

    “None of the 24 studies using LCA to identify classes of syndemic determinants tested the nature of the interaction between these factors to determine synergy as opposed to comorbidity.”

    From Recommendations for empirical syndemics analyses: A stepwise methodological guide (2024) · cites this paper as [48]

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Authors
Hill, A. V., De Genna, N. M., Perez-Patron, M. J., Gilreath, T. D., Tekwe, C., & Taylor, B. D.
Affiliations
  • Texas A&M University System (US)
  • Texas A&M University (US)
  • Temple University (US)
Corresponding author
  • Hill, Ashley V.
  • Taylor, Brandie DePaoli
ORCID
Venue
Journal of Adolescent Health
Publisher
Elsevier BV
Published
2019-03
Volume
64
Issue
3
Pages
319-326
ISSN
1054-139X (ISSN-L)
DOI
10.1016/j.jadohealth.2018.09.006
OpenAlex
W2901901280
Cited by
26
References
31
Citations by year
2026: 3 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 2 · 2020: 6 · 2019: 1
FWCI
3.45
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Adolescent Health (publishedVersion)
  • PubMed (publishedVersion)
Funders
Health Resources and Services Administration (1 R40MC307600100)
Topics
  • Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
  • Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
  • Social Sciences › General Social Sciences › HIV, TB, and STIs Epidemiology
Keywords
syndemic theory, sexually transmitted infections, young adults, STI risk factors, gender differences, racial and ethnic disparities, depression, substance use, socioeconomic factors, poverty, chlamydia, HIV, herpes simplex virus, minority women, sexual behavior
MeSH terms
Syndemic, Adolescent, Adult, Black or African American, Female, Hispanic or Latino, Humans, Male, Nutrition Surveys, Risk Factors, Sexual Behavior, Sex Factors, Sexually Transmitted Diseases, Socioeconomic Factors, United States, White People, Young Adult

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