But the picture is more complicated when it comes to the high STD rates among minorities. Gay and bisexual men make up the vast majority of new syphilis cases. In L.A. County, syphilis rates among African American women are six times higher than white women and three times higher than Latina women.
Northover said that officials need to evaluate what’s called structural or systemic racism, the way housing or education policies may negatively impact people and their health. Studies have found, for example, that people with HIV who had low levels of literacy were less likely to follow their treatment, and that poorer Americans were more likely to engage in risky sexual behavior, increasing their risk of STDs.
The Centers for Disease Control and Prevention released a white paper in 2010 saying the country could not close disparities in STD rates without addressing “the interpersonal, network, community, and societal influences of disease transmission and health.”
But that’s a tall order given how entrenched many social problems are.
Poverty or a lack of opportunity may be forcing women to exchange sex for resources, leading to the spread of STDs, Northover said. There also tends to be a mistrust of the medical system among African Americans, making them reluctant to seek care. Certain neighborhoods may be excluded from access to healthcare because of geography or finances, she said.
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