Perceived Stress, Sexually Transmitted Infection, and Pelvic Inflammatory Disease: Examination of Differences in Associations among Black and White Women

Citation

Scheidell, J. D.; Thorpe, L. E.; Adimora, A. A.; Caniglia, E. C.; Lejuez, C. W.; Troxel, A. B.; & Khan, M. R. (2020). Perceived Stress, Sexually Transmitted Infection, and Pelvic Inflammatory Disease: Examination of Differences in Associations among Black and White Women. Sex Transm Dis.

Abstract

INTRODUCTION: Perceived stress is linked to poor sexual and reproductive health, but its relationship with sexually transmitted infections (STI) is less clear. The elevated burden of stress and STI among Black women suggests a need to examine racial differences in the associations on additive and multiplicative scales. METHODS: Using data from Black and White female participants from Wave IV of the National Longitudinal Study of Adolescent to Adult Health (n=4,744), we examined the association of high stress (scores ≥6 on the Perceived Stress Scale-4) with self-reported past year chlamydia diagnosis; combined curable STI; and lifetime pelvic inflammatory disease using modified Poisson regression with robust variance to estimate prevalence ratios (PRs) and prevalence differences (PDs). Models included a race-stress product-interaction term and adjusted for sociodemographic variables, prior trauma and stressors, and mental health factors. RESULTS: In unadjusted analyses, stress was associated with STI among Black and White women. Adjusted associations were attenuated among White women; among Black women, stress remained associated with chlamydia (adjusted PR (APR)=2.22, 95% CI 1.30 - 3.79) and curable STI (APR=1.59, 95% CI 1.05 - 2.40), corresponding to approximately 5 excess cases of each. Among White women, poverty and personality traits were the strongest confounders; among Black women, poverty, trauma, and neurotic personality traits were the strongest confounders for chlamydia, although no factors appeared to confound the association with curable STI. CONCLUSIONS: Stress is independently linked to STI, particularly among Black women. Additional research with longitudinal data is needed to understand the role of stress on STI and address a significant health disparity.

URL

https://doi.org/10.1097/OLQ.0000000000001232

Keyword(s)

STI

Reference Type

Journal Article

Journal Title

Sex Transm Dis

Author(s)

Scheidell, J. D.
Thorpe, L. E.
Adimora, A. A.
Caniglia, E. C.
Lejuez, C. W.
Troxel, A. B.
Khan, M. R.

Year Published

2020

DOI

10.1097/olq.0000000000001232

Reference ID

6197