Discrimination and sexual risk among young urban pregnant women of color

Abstract

Objective: Discrimination predicts increased risk for many negative health outcomes, helping explain a variety of racial and socioeconomic health disparities. Recent research suggests discrimination may play a role in disparities in HIV and other sexually transmitted infections (STIs); however, this research has focused on risk behaviors and has yet to establish a link between discrimination and STI diagnosis specifically. This investigation tested whether discrimination predicted condom use, risky sexual partners, and self-reported STI diagnosis among a population disproportionately affected by HIV and STIs in the U.S.: young, pregnant, socioeconomically disadvantaged, women of color.

Method: During second and third trimesters, 885 mostly Latina and Black pregnant women, 14-21 years old, attending 14 hospitals and health centers in New York City for prenatal care, completed interviews.

Results: Greater discrimination during second trimester predicted greater odds of STI diagnosis and having a risky sexual partner during third trimester, but not condom use. Whether discrimination was attributed to race, identifying as Black, or identifying as Latina did not moderate effects.

Conclusion: This is the first investigation establishing a link between discrimination and STI diagnosis, not just risk behavior. It does so among a sample of at-risk, young, pregnant, women of color. Findings suggest implications for sexual risk during pregnancy and across the life span, and risks for the pregnancy and fetus. It is vital to reduce discrimination to eliminate disparities in HIV and STIs. Future research should continue examining the role of discrimination in sexual risk among different populations and work to uncover potential mechanisms.