TITLE:
Incidence of Gonorrhea and Chlamydia in Urban Settings: The Case for Neighborhood Level Analysis in Boston
AUTHORS:
Catherine Cattley, Paola Massari, Caroline A. Genco
KEYWORDS:
Gonorrhea, Chlamydia, Social Determinants of Health, Poverty, Boston
JOURNAL NAME:
Advances in Infectious Diseases,
Vol.5 No.4,
November
30,
2015
ABSTRACT: The sexually transmitted
infections (STIs) gonorrhea and chlamydia are known to disproportionately
affect impoverished communities and communities of color, especially in urban
areas. Moreover, socioeconomic and demographic factors such as poverty and
race/ethnicity may contribute to a difference in treatment setting choice as
well as a delay in care seeking. In an urban metropolitan area such as Boston,
the overall gonorrhea and chlamydia rates are higher than national rates, and
such differences are even more marked in certain neighborhoods with greater
proportions of individuals who are impoverished, young, and of color. Using a
retrospective analysis of city wide data, we highlight the effects of
socioeconomic and demographic variables on urban STI prevalence. High poverty
rates, race/ethnicity and younger adult populations are linked to
disproportionately high STI rates. Interestingly, STI rates do not appear to be
influenced by the universal health care coverage offered to the whole
Massachusetts’ resident populations. We examine the effects of these variables
in Boston neighborhoods in conjunction to STI rates and hypothesize that the
observed rates are underestimates of the true prevalence of infection. Future
studies will investigate how these same socioeconomic and demographic factors
influence which treatment settings are chosen and subsequently lead to a delay
in treatment.