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The target population is heterosexuals, low-income African-Americans, ages 18 to 25 residing in San Francisco, California. In San Francisco, African American young adults are at higher risk for acquiring gonorrhea infection relative to other races/ ethnicities’ youth adults. Respectively, in 2010, the target population ages 15-19 had an incidence rate of 2301. 2 and ages 20-24 had an incidence rate of 2696. 7 for gonorrhea. In comparison, in 2010, Caucasians age 15-19 had an incidence rate of 152. 8 and age 20-24 had an incidence rate of 382. 4 for gonorrhea. Hence, the rate of gonorrhea in San Francisco surpasses those for Los Angeles, CA Metropolitan Statistical Area (MSA), the state of California, New York, NY MSA, and the United States in 2010 (2012).
Increasingly, investigators are seeking to identify determinants of STI acquisition among young adults from failing to use condoms/prophylactic and volume of sex partners. Investigators have thus begun to focus attention on understanding exposure to infected partners by exploring characteristics of young adults’ sexual networks. Research suggests that young adults whose sex partners are having sex with other partners are at higher vulnerability for an exposure to an STI. Conversely, these studies are finite.
The target populace is residing in an elevated STI prevalence community — whose sex partners have other sex partners outside their local network. Therefore, their local network is more prone to have at least one sex partner infected with gonorrhea. Since, the exposure to an STI is related to the presence of sexual links between his or her recent sex partners and the community. Furthermore, there also are noticeable racial inequalities with incarceration rates in the target populace, in part due to the War on Drugs, comprising of racial bias in arrests and sentencing, and other structural factors. In San Francisco, 6 percent of inhabitants are Black, yet 56 percent of inmates’ population are Black. African Americans, age 18 to 25, represent the largest portion of the inmate demographics (2013). This disproportionate incarceration of Black males, in part, disrupts the sexual networks, and hypothesized to have an essential role in the race disparity in STIs. It suggests that a history of incarceration is a clear risk factor for STI/HIV and sexual risk behavior.
Social control theory puts forth an explanation for the relationship between rates of STI and rates of crime that presumes criminality erodes community unity and perceptions of social control, thus constructing an environment conducive to higher rates of risky sexual behaviors and STI infections. Plus, the primary policy response to growing crime trends in the USA involved incarcerating large portions of residents in urban neighborhoods further eroding open avenues of social control, cohesion, capital, and collective efficacy. The research suggests that neighborhoods that meet these sociological profiles have higher rates of sexual risk behaviors and STI.
Despite accumulating research into community factors, aggregate rates of crime, and STIs, hardly any researchers account for structural dependence in the geographical data. The research found a considerably positive relationship between rates of incarceration and census-tract-level incidence rates of STIs among young women in San Francisco, CA after adjusting for poverty and other socioeconomic influences. A secondary audience is African-American Men who have sex with men (MSM), age 17-25 residing in San Francisco, CA. MSM represent 72% of the gonorrhea cases. The secondary populace has considerably higher rates of gonorrhea in comparison to their white counterparts. Several studies have established that an increased incidence of STIs among African-American MSM with higher HIV risk, which makes African-American MSM a valid secondary audience.
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