The findings and conclusions in these presentations have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.

Tuesday, May 9, 2006
185

Sexually Transmitted Infections (STIs) and Public Housing – the jury is out

Jacky M. Jennings, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Bayview Medical Center, Pediatrics - AHRG, 5200 Eastern Ave, Mason F. Lord Bldg - Center Towers 4th floor, Baltimore, MD, USA and Jonathan Ellen, Johns Hopkins University School of Medicine, Baltimore, MD.


Background:
African American, impoverished urban neighborhoods are disproportionately affected by rates of STIs including HIV. Not all of these neighborhoods, however, are at equal risk and features of the built and social environment, such as public housing, may explain the increased vulnerability. High density public housing sets up areas of concentrated poverty and may facilitate the existence of high risk sexual networks including networks with a high prevalence of drug use, discordant partnering by age, and/or concurrency.

Objective:
The goal of this study is to examine the relationship between public housing and rates of gonorrhea among African American, impoverished urban census block groups (cbgs).

Method:
Gonorrhea cases reported in 2002 and public housing (37) were geocoded to cbgs. Census 2000 data including percent African American, percent in poverty, and total population ages 15-49 years, were extracted and gonorrhea rates were calculated. Cbgs of >50% African American and >20% in poverty were selected. Using ecologic analysis in linear regression, the relationship between public housing and gonorrhea rate was determined. Exploratory analysis only, due to power concerns, by public housing type - high vs. low density – was conducted.

Result:
97% (4,371/6,196) of the 72.5% gonorrhea cases (4,371) with residential addresses were geocoded. All public housing (37) was geocoded to 31cbgs. 42% (295/710) of cbgs and 81% (25/31) of cbgs with public housing were selected for analysis. In linear regression, public housing was not significantly associated with gonorrhea rates; although public housing was significantly associated with percent poverty (&#61538; 9.20, CI: 4.19, 14.21, p<.01). Exploratory analysis on public housing type suggested qualitatively different effects.

Conclusion:
Public housing was not significantly associated with gonorrhea rates, although, there may be interesting differences by type – high vs. low density.

Implications:
Further research is warranted to explore the relationship between STIs and public housing type, location, and sexual networks within public housing.