Sexually transmitted infections (STIs) disproportionately impact non-Hispanic blacks in the United States. Racial differences in sexual networks can contribute to these disparities. Racial residential segregation, the separation of racial groups in a residential context, is a community factor known to influence sexual networks and has been associated with negative health outcomes. Our objective was to examine the association between racial residential segregation (henceforth, referred to as segregation), risky sexual behavior, concurrent partnerships, and STI diagnoses among non-Hispanic blacks. Demographic, sexual behavior, and STI diagnosis data for non-Hispanic blacks 15–44 years of age were obtained from the 2006–2010 National Survey of Family Growth. Segregation and community poverty data were obtained from the U.S. Census. Five distinct dimensions measured segregation, each with a representative index. Multilevel logistic regressions were conducted to test how each of the five indices were associated with risky sexual behavior, concurrent partnerships, and STI diagnoses. Risky sexual behavior results showed 16.1% (n=588) of participants engaged in risky sexual behavior. The association was stronger for the absolute centralization (adjusted odds ratio [aOR] 2.07; 95% confidence interval [CI] 2.05 – 2.08) and relative concentration indices (aOR 2.05; 95% CI 2.03 – 2.07). This suggests risky sexual behavior is most strongly associated with segregation in neighborhoods with a high density of non-Hispanic blacks and accumulation of non-Hispanic blacks in an urban core. STI diagnosis results showed 7.4% (n=305) of participants reported a STI diagnosis, and segregation was associated with STI diagnosis. The association was strongest measured with the dissimilarity index (aOR 2.41; 95% CI 2.38 – 2.43) and stronger for males. Concurrent partnerships results showed 15.6% (n=645) of participants reported concurrent partnerships. Multilevel analyses showed segregation to be associated with concurrent partnerships with the association strongest measured with the dissimilarity index. Segregation acted as a risk and a protective factor with risky sexual behavior, concurrent partnerships, and STI diagnosis, depending on the segregation measure. Additional work is needed to understand the mechanisms of how specific segregation dimensions influence risky sexual behaviors and sexually transmitted infections.

Abstract Purpose: The United States has the highest rate of teen pregnancy of any industrialized nation. Adolescents who have their first sexual intercourse at a young age are at increased risk for teen pregnancies and acquiring a sexually transmitted disease. This study examines predictors of early onset sexual intercourse in male and female residents of the United States. Methods: A nationally representative sample of N=7,643 females and N=4.928 males ages 15-44 was procured from the 2002 National Survey of Family Growth (NSFG), Cycle 6. Age at first sexual intercourse was used to define early onset of sexual debut(<18 years). Socio-demographic and behavioral characteristics of the respondents, demographic and selected reproductive characteristics of the respondent's parents were examined using multiple logistic regression modeling. Results: Non-fispanic black, being raised without both parents, having a mother less than 18 years old at the age of first birth and age difference between partners were significant predictors of early onset of sexual intercourse for both males and females. Maternal education less than high school was a significant protective factor for female respondents [OR=0.72 (95%CI=0.58- 0.90)] and paternal education completed high school only [OR=1.4 (95% CI=l. 1-1.7)] was a significant risk factor for male respondents. Conclusions: Racelethnicity, age difference between partners, not being raised by both parents, having a mother who had her first birth before the age of 18 and parental education are important predictor variables. Further study should be conducted to investigate the protective effect of lack of maternal education for female respondents. Intervention programs for teen pregnancy and sexually transmitted infection prevention should target these at risk groups.