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. 2013 Nov;23(11):716-9.
doi: 10.1016/j.annepidem.2013.08.002. Epub 2013 Oct 5.

Sex ratio, poverty, and concurrent partnerships among men and women in the United States: a multilevel analysis

Adaora A Adimora  1 , Victor J Schoenbach, Eboni M Taylor, Maria R Khan, Robert J Schwartz, William C Miller
Affiliations

Sex ratio, poverty, and concurrent partnerships among men and women in the United States: a multilevel analysis

Adaora A Adimora et al. Ann Epidemiol. 2013 Nov.

Abstract

Purpose: Social and economic contextual factors may promote concurrent sexual partnerships, which can accelerate population HIV transmission and are more common among African Americans than U.S. Whites. We investigated the relationship between contextual factors and concurrency.

Methods: We analyzed past 12-month concurrency prevalence in the 2002 National Survey of Family Growth and its contextual database in relation to county sex ratio (among respondent's racial and ethnic group), percentage in poverty (among respondent's racial and ethnic group), and violent crime rate. Analyses examined counties with balanced (0.95-1.05 males/female) or low (<0.9) sex ratios.

Results: Concurrency prevalence was greater (odds ratio [OR]; 95% confidence interval [CI]) in counties with low sex ratios (OR, 1.67; 95% CI, 1.17-2.39), more poverty (OR, 1.18; 95% CI, 0.98-1.42 per 10 percentage-point increase), and higher crime rates (OR, 1.04; 95% CI, 1.00-1.09 per 1000 population/year). Notably, 99.5% of Whites and 93.7% of Hispanics, but only 7.85% of Blacks, lived in balanced sex ratio counties; about 5% of Whites, half of Hispanics, and three-fourths of Blacks resided in counties with >20% same-race poverty.

Conclusions: The dramatic Black-White differences in contextual factors in the United States and their association with sexual concurrency could contribute to the nation's profound racial disparities in HIV infection.

Keywords: African Americans; Concurrent partnerships; Epidemiology; HIV; Hispanics; Multilevel analysis; Sex ratio.

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References

    1. Adimora A, Schoenbach V, Bonas D, Martinson F, Donaldson K, Stancil T. Concurrent Sexual Partnerships among Women in the United States. Epidemiology. 2002;13:320–327. - PubMed
    1. Adimora AA, Schoenbach VJ, Doherty IA. Concurrent sexual partnerships among men in the United States. Am J Public Health. 2007;97:2230–2237. - PMC - PubMed
    1. Adimora AA, Schoenbach VJ, Taylor EM, Khan MR, Schwartz RJ. Concurrent partnerships, nonmonogamous partners, and substance use among women in the United States. Am J Public Health. 2011;101:128–136. - PMC - PubMed
    1. Adimora AA, Schoenbach VJ, Martinson FE, Coyne-Beasley T, Doherty I, Stancil TR, et al. Heterosexually transmitted HIV infection among African Americans in North Carolina. J Acquir Immune Defic Syndr. 2006;41:616–623. - PubMed
    1. Adimora AA, Schoenbach VJ. Contextual Factors and the Black-White Disparity in Heterosexual HIV Transmission. Epidemiology. 2002;13:707–712. - PubMed

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