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

Joy D. Scheidell, Lorna E. Thorpe, Adaora A. Adimora, Ellen C. Caniglia, Carl W. Lejuez, Andrea B. Troxel, Maria R. Khan

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: Perceived stress is linked to poor sexual and reproductive health, but its relationship with sexually transmitted infections (STIs) 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 = 4744), 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 and prevalence differences. 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 prevalence ratio, 2.22; 95% confidence interval, 1.30-3.79) and curable STI (adjusted prevalence ratio, 1.59; 95% confidence interval, 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 seemed 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.

Original languageEnglish (US)
Pages (from-to)617-624
Number of pages8
JournalSexually Transmitted Diseases
Volume47
Issue number9
DOIs
StatePublished - Sep 1 2020

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)
  • Infectious Diseases

Fingerprint Dive into the research topics of 'Perceived Stress, Sexually Transmitted Infection, and Pelvic Inflammatory Disease: Examination of Differences in Associations Among Black and White Women'. Together they form a unique fingerprint.

Cite this