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Racial/Ethnic Differences in Young Women's Health-Promoting Strategies to Reduce Vulnerability to Sexually Transmitted Infections

Identifying the various strategies young women use to prevent STI transmission will help narrow focus on stronger prevention techniques.

Photo of Asher
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Young women of color in the United States are disproportionately affected by sexually transmitted infections (STIs). We characterize the protective behaviors used by young women to reduce their vulnerability to STI acquisition and examine howSTI prevention strategies differ by race/ethnicity.

From 2015 to 2016, women aged 13e24 years presenting to five Northern California family planning clinics were surveyed about their STI prevention strategies. The chi-squared tests and multivariable logistic regression identified associations between race/ethnicity and use of sexual health-promoting strategies.

Among 790 women, the most common strategies included condom use (67%), asking partners about STIs (47%), limiting sexual partners (35%), frequent STI screening (35%), and asking partners about other sexual partners (33%). Black, Hispanic, and Asianwomen had decreased odds of utilizing strategies before intercourse compared with white women (adjusted odds ratio [aOR]black:
.25, confidence interval [.14e.47]; aORHispanic: .36, CI [.20e.65]; aORAsian: .44, CI [.23e.84]). Black women had decreased odds of using strategies requiring partner involvement (aORblack: .35, CI [.13e.92]). Whitewomenwere more likely to report that providers discussed condoms (aOR: 2.53, CI [1.04e6.15]) and talked to partners about STIs (aOR: 2.56, CI [1.52e4.32]) compared with nonwhite women. Black and Hispanic women were more likely to feel very uncomfortable discussing lifetime sexual partners (aORblack: 4.26, CI [1.36e13.30] and aORHispanic: 5.35, CI [1.79e15.99]) and condom use (aORblack: 3.05, CI [1.14e8.15] and aORHispanic: 2.86, CI [1.11e7.35]) with providers.

Young women use diverse strategies to prevent STIs that vary by race/ethnicity. Providers can use these findings to improve sexual health counseling and promote equitable education and services.


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Photo of Anne-Laure Fayard

Great insight on variations among different racial / ethnic groups Asher which indeed raises an important issue of how to adjust strategies in terms of education, counseling and access to resources and services. Interestingly we saw these variations (along different criteria - ethnicity, religion, socio-economic status, urban vs. rural) emerge in several posts in different countries. I believe that keeping this in mind will be important for ideation. If a "one size fits all" strategy does not work, how can we create solutions that are flexible enough to be used and adapted by all. Maybe universal design is an option to explore. Thank you again!

Photo of Ashley Tillman

Thanks Asher for sharing! To add to Anne-Laure's point it's exciting to think about how solutions might take into account the many different factors that influence health outcomes. Here's a quick resource to start brainstorming some of the factors that influence positive health outcomes: