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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Geospatial disparities in youth sexually transmitted infections during COVID-19
American journal of preventive medicine
26 Feb 2024
PMID: 38417592
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
: Early in the COVID-19 pandemic, routine sexually transmitted infection (STI) screenings decreased, and test positivity rates increased due to limited screening appointments, national-level STI testing supply shortages, and social distancing mandates. It is unclear if adolescent preventive STI screening has returned to pre-pandemic levels and if pre-existing disparities worsened in late-pandemic.
: This cross-sectional study examined 22,974 primary care visits by 13-19-year-olds in the Philadelphia metropolitan area undergoing screening for gonorrhea and chlamydia in a 31-clinic pediatric primary care network during 2018-2022. Using interrupted-time-series analysis and logistic regression, pandemic-related changes in the asymptomatic STI screening rate and test positivity were tracked across patient demographics. Neighborhood moderation was investigated by census-tract-level Child Opportunity Index in 2023.
: The asymptomatic STI screening rate dropped by 27.8 percentage points (pp) and 13.5pp when the pandemic and national STI test supply shortage began, respectively, but returned to pre-pandemic levels after supply availability was restored in early 2021. Non-Hispanic-Black adolescents had a significant pandemic drop in STI screening rate, and it did not return to pre-pandemic levels (-3.6 pp in the late-pandemic period, p< 0.01). This decrease was more pronounced in socioeconomically and educationally disadvantaged neighborhoods (7.5 pp and 9.9 pp lower, respectively) than in advantaged neighborhoods (both p< .001), controlling for sex, age, insurance type and clinic characteristics.
: Neighborhood socioeconomic and educational disadvantage amplified racial-ethnic disparities in STI screening during the pandemic. Future interventions should focus on improving primary care utilization of non-Hispanic-Black adolescents to increase routine STI screening and preventive care utilization.
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Details
- Title
- Geospatial disparities in youth sexually transmitted infections during COVID-19
- Creators
- Jungwon Min - Children's Hospital of PhiladelphiaStephen Bonett - University of PennsylvaniaVicky Tam - Children's Hospital of PhiladelphiaSpandana Makeneni - Children's Hospital of PhiladelphiaNeal D. Goldstein - Drexel UniversitySarah Wood - University of Pennsylvania
- Publication Details
- American journal of preventive medicine
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001275632700001
- Scopus ID
- 2-s2.0-85189093713
- Other Identifier
- 991021860110704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health