Sexually transmitted disease

Introduction

Racial disparities are mainly visible among the young people. Blacks comprise 67% of STIs and HIV positive youth from ages 13-19 (CDC, 2014). Sexually active teenagers expose themselves to high risks of sexually transmitted infections (STIs), and most youth populations experience a high rate of these infections. The African American young women are mainly at risks in the United States. African Americans suffer a great deal from the adverse sexual health outcomes at a much more disproportionate rate. Young females who have sex with men are mainly at risk of STIs (Sternberg, Forhan, & Gottlied, 2009). The prominent misconception is that teenage African Americans females are not careful in protecting their reproductive and sexual health as compared to their whites’ counterparts. However, close examination indicates that the extent of STI epidemics and its causes show a much more complex picture. For better combating the STI epidemics among these young females it is necessary to examine how poverty, racism, incarceration among other social aspects contributes to increased risks.

Discussion

Determinants of the Health Disparities

Individual/Interpersonal Determinants

The term sorting describes the tendency of people who share the same characteristics to associate with one another. Sorting is in the form of age and race. Sorting can be a protective factor for members of the low-risk networks when members only make sexual contact with those of their network (Berman, Weinstock, & Cates, 2004). It leads to low risks. Sorting can also contribute to the major risk of infection among the high-risk network members (Lenoir, and Alder. et al. 2006).

 Sorting is, therefore, an interpersonal determinant on people’s attitude showing the reason behind the high rate of sexually transmitted infections among African American teenage females. Other factors at an individual level include protective behaviors and sexual risks. There are also individual characteristics such as psychological states, personality traits, individual cognitions, and self-efficacy (Forhan et al., 2009). There is also the relationship factors like age of partner and length of the relationship. Familial characteristics are also other determinants such as parental support and parental monitoring. Other individual level determinant factors include drug use and drug injection practices.

Organization/Community Determinants

The community and organization determinants are the circumstances in which people socialize, grow, work and establish relationships. Community factors such as poverty, school connectedness and availability of condoms are factors contributing to the health issue disparity. Media exposure is also another societal factor that may influence young people to engage in risky sexual behaviors. Social factors include cultural norms, social networks, and organizations like church, schools and workplace which can facilitate or impede efforts of avoiding the transmission of diseases.

▫ Policy Determinants

Policy and legal aspects shape environments which can facilitate or impede disease transmission. These policies have a direct relation to social factors such as labor/ wage policies healthcare policy and federal assistance policies. These policies shape conditions of people health, well-being, social and economic conditions, they determine conditions for employment, early childhood development, job security, education, health services and access to services. They also determine access to housing, social stigma and social exclusion (Upchurch, 2004).

• Analytical Framework

▫ Theory

LaVeist Physiognomy Model shows how ethnicity and race influence health disparities. This conceptual model by LaVeist, (1994) shows clear interpretations of the behavioral and social factors that influence race disparities ( LaVeist, 1994). This model fits in explaining the determinants of STI among black female teenagers (Satterwhite, et al., 2008).

▫ Social Justice Perspective

Racial health disparities show the relationships in terms of differences in races in the social-economic status.

▫ Ecological Approach

The ecological approach can be used to eliminate disparities in health and calls for attention to both the social condition and environmental hazards (DiClemente, Salazar, Crosby, 2007).

Public Health Interventions

There are interventions that target factors at an individual level that link to STI risks and do not address the high-level factors such as media influence and peer norms. There are also interventions for young adults and at –risk adolescents that address the underlying cultural and social conditions that impact on sexual –risky behaviors. The strategies aim to improve the underlying social conditions. 

Conclusion

The determinants of health disparity include policy determinants, community/ organizational determinants, and interpersonal/ individual determinants. STD/HIV preventive interventions for teenagers address environmental and social effects using ecological approaches. Both social conditions and environmental hazards need to be put under considerations when eliminating disparities of health (Sieving, 2011). Interventions for the at-risk adolescents are successful in addressing the underlying cultural and social conditions that affect sexual risk-taking behaviors. Data collection has to be done that will help to monitors national trends of STIs.

References

Berman, S Weinstock, H & Cates, W (2004). Sexually Transmitted Disease among American youth Perspectives on sexual and reproductive health 36 (1)
CDC (2014). Health Disparities in STD, HIV/AIDS, TB, and STD.
Sternberg, R Forhan, S & Gottlied, L (2009). Prevalence of sexually transmitted infections among the female adolescents aged 19-19 in the United States. Pediatrics 124
Satterwhite CL, Torrone E, Weinstock H. Sexually transmitted infections among US women and man: prevalence and incidence estimates;40. 187-93.
Forhan SE, Gottlieb SL, Sternberg MR, Xu F, Markowitz L (2009). sexually transmitted infections among female adolescents.
DiClemente R, Salazar L, Crosby R (2007). STD/HIV preventive interventions for adolescents an ecological approach. 32 (8): 888-906.
Sieving RE, Bernat D, Plowman S, et al. (2011). A clinic-based program to reduce sexual risk behaviors. Health Promot Pract
Upchurch D, Mason W, Kriechbaum M (2004) behavioral determinants of self-reported STD. Sex Reprod Health. 36:276-287.
Lenoir, C, Alder, N., et al. (2006) Perceptions of partner reported behavior. Journal of Adolescent Health. 38:179-185.
LaVeist, A (1994) ethnicity, race, and health. Public health reader. P 350. San Francisco. Jossey-Bass

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