A study of Southern sexual minority African American women found associations between psychosocial stressors (depressive symptoms, incarceration, intimate partner violence) and STI history.
Published in LGBT Health, the study describes how multiple minority stress among sexual minority African American women may contribute to sexual health disparities. These women face stigma and discrimination in a variety of settings because of their marginalized identities, and this may impact social and economic status such that sexual risk behavior is elevated.
The study found that reported depressive symptoms were associated with both alcohol/drug use at last sexual encounter (with a male or female partner) and STI diagnosis at enrollment. Additionally, the authors report that a history of incarceration was associated with exchange of sex for money/drugs with male sexual partner history and a history of any STI; they report that this result may be due to the high risk of incarceration faced by commercial sex workers and the limited employment opportunities for former inmates. There was also a significant association between intimate partner violence and trichomoniasis–the authors present a possible mediating factor of women in abusive relationships feeling uncomfortable negotiating barrier method use with sexual partners.
The study also presents several suggestions for healthcare providers and public health programs. Because of the high incidence of depressive symptoms and the association with STI diagnoses, the authors suggest that providers screen for and treat both depression and STIs among this specific population. They also recommend that providers note how common intimate partner violence is among sexual minority African American women and routinely screen for intimate partner violence, substance abuse, and STIs, especially trichomoniasis (which can increase both HIV acquisition and transmission among women).
You can access the full text in LGBT Health here: https://www.liebertpub.com/doi/10.1089/lgbt.2017.0263