Proximity to Screening Site, Rurality, and Neighborhood Disadvantage: Treatment Status among Individuals with Sexually Transmitted Infections in Yakima County, Washington.

Solmaz Amiri,Andre Fresco,Christine D Pham,Melissa Sixberry,John M Roll,Oladunni Oluwoye,Ofer Amram,Karl C Alcover,Michael G Mcdonell,Lilian Bravo

doi:10.3390/ijerph17082679

Abstract

Background: Early sexually transmitted infections (STIs) diagnosis facilitates prompt treatment initiation and contributes to reduced transmission. This study examined the extent to which contextual characteristics such as proximity to screening site, rurality, and neighborhood disadvantage along with demographic variables, may influence treatment seeking behavior among individuals with STIs (i.e., chlamydia, gonorrhea, and syphilis). Methods: Data on 16,075 diagnosed cases of STIs between 2007 and 2018 in Yakima County were obtained from the Washington State Department of Health Database Surveillance System. Multilevel models were applied to explore the associations between contextual and demographic characteristics and two outcomes: (a) not receiving treatment and (b) the number of days to receiving treatment. Results: Contextual risk factors for not receiving treatment or having increased number of days to treatment were living ≥10 miles from the screening site and living in micropolitan, small towns, or rural areas. Older age was a protective factor and being female was a risk for both outcomes. Conclusions: Healthcare providers and facilities should be made aware of demographic and contextual characteristics that can impact treatment seeking behavior among individuals with STIs, especially among youth, females, and rural residents.

Highlights

Over two million people annually in the United States are diagnosed with sexually transmitted infections (STIs) including chlamydia, gonorrhea, and syphilis [1]
The purpose of this study was to examine (a) whether the likelihood of not receiving treatment varied by proximity to screening sites, socio-economic context of the area of residence, and rurality; and (b) whether the number of days to treatment varied by proximity to screening sites, socio-economic context of the area of residence, and rurality among those who were treated for STIs
Contextual risk factors for not receiving treatment were living ≥10 miles from the screening site (OR = 1.27, 95% confidence intervals (CIs) = 1.05–1.53, p = 0.01) and living in micropolitan, small towns, or rural areas (OR = 1.40, 95% CI = 1.13–1.72, p = 0.002)

Summary

Introduction

Over two million people annually in the United States are diagnosed with sexually transmitted infections (STIs) including chlamydia, gonorrhea, and syphilis [1]. In 2018, the United States rates of chlamydia, gonorrhea, and syphilis were 539.9, 179.1, and 10.8 per 100,000 population, respectively [1]. Yakima County rates of chlamydia were 702.2, while Washington State had a rate of. This study examined the extent to which contextual characteristics such as proximity to screening site, rurality, and neighborhood disadvantage along with demographic variables, may influence treatment seeking behavior among individuals with STIs (i.e., chlamydia, gonorrhea, and syphilis). Methods: Data on 16,075 diagnosed cases of STIs between 2007 and 2018 in Yakima County were obtained from the Washington State Conclusions: Healthcare providers and facilities should be made aware of demographic and contextual characteristics that can impact treatment seeking behavior among individuals with STIs, especially among youth, females, and rural residents

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Methods

Results

Discussion

Conclusion