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Background: Rising costs and decreased funding make it essential that sexually transmitted infections (STI) prevention programs evaluate where to most efficiently concentrate efforts.
Objectives: To conduct a geographic assessment and identify communities disproportionately impacted by STI with the greatest need for intervention.
Methods: Data from 2004-2008 were used to identify a cohort of individuals infected with CT, GC, Early Syphilis, or HIV from STD*MIS and eHars in Denver County. All records were geocoded to the census tract level. A comprehensive Risk Index Score was calculated from the 4 individual STI rates within each tract with an areas risk score increasing by one point every time it was found to have an individual STI rate that was at least three times the Denver average.
Results: A single census tract was identified with the highest risk score. Further analysis revealed this area to be somewhat older (median age 42 years), predominantly Hispanic (61.4%), and low household income (median $35,694), compared to $42,861 for Denver as a whole. High unemployment rates were seen (25.7%, compared to 7.3% for Denver), with over 70% (compared to 34.9% for Denver) of the population falling below 150% of the federal poverty level.
Conclusions: Contextual factors such as geographic, demographic, economic, and social composition are important determinants when planning interventions.
Implications for Programs, Policy, and/or Research: There is a major shift of focus from provider-delivered messages to involvement of the community in developing a tailored prevention plan that aims to influence social factors, including community norms and community empowerment that affect risk behaviors at the individual level. Our analyses will assist in targeting such a plan in the Denver Metro area.