Variation in Patterns of Racial and Ethnic Disparities in Primary and Secondary Syphilis Diagnosis Rates Among Heterosexually Active Women by Region and Age Group in the United States

• Type of Material: Article
• Authors: Erika G Martin, Rockefeller College of Public Affairs and Policy; Bahareh Ansari, Homeland Security and Cybersecurity; Eli Rosenberg, Emory University; Rachel Hart-Malloy, Center for Collaborative HIV Research in Practice and Policy; Dawn Smith, Divisions of ∥HIV Prevention; Kyle Bernstein, Emory University; Harrell W Chesson, Centers for Disease Control and Preventiont; Kevin Delaney, Centers for Disease Control and Prevention; Monica Trigg, Emory University; Thomas L Gift, Centers for Disease Control and Prevention
• Language: English
• Date: 2022-05-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Final Published Version
• Copyright Statement: Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/OLQ.0000000000001607
• Title of Journal or Parent Work: SEXUALLY TRANSMITTED DISEASES
• Volume: 49
• Issue: 5
• Start Page: 330
• End Page: 337
• Grant/Funding Information: This work was supported by Centers for Disease Control and Prevention/National Center for HIV, Viral Hepatitis, STD, and TB Prevention Epidemiological and Economic Modeling Agreement (No. 5U38PS004650).
• Keywords: Life Sciences & Biomedicine; PREVALENCE; Infectious Diseases; HEALTH; HIV; GONORRHEA; Science & Technology
• Research Categories: Health Sciences, Epidemiology; Biology, Biostatistics

Abstract

Background Syphilis rates have increased substantially over the past decade. Women are an important population because of negative sequalae and adverse maternal outcomes including congenital syphilis. We assessed whether racial and ethnic disparities in primary and secondary (P&S) syphilis among heterosexually active women differ by region and age group. Methods We synthesized 4 national surveys to estimate numbers of heterosexually active women in the United States from 2014 to 2018 by region, race and ethnicity, and age group (18-24, 25-29, 30-44, and ≥45 years). We calculated annual P&S syphilis diagnosis rates, assessing disparities with rate differences and rate ratios comparing White, Hispanic, and Black heterosexually active women. Results Nationally, annual rates were 6.42 and 2.20 times as high among Black and Hispanic than among White heterosexually active women (10.99, 3.77, and 1.71 per 100,000, respectively). Younger women experienced a disproportionate burden of P&S syphilis and the highest disparities. Regionally, the Northeast had the highest Black-White and Hispanic-White disparities using a relative disparity measure (relative rate), and the West had the highest disparities using an absolute disparity measure (rate difference). Conclusions To meet the racial and ethnic disparity goals of the Sexually Transmitted Infections National Strategic Plan, tailored local interventions that address the social and structural factors associated with disparities are needed for different age groups.