Multiple chlamydia infection among young women: comparing the role of individual- and neighbourhood-level measures of socioeconomic status

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Abstract

Background

Young women have the highest burden of chlamydia infections, and socioeconomic disparities exist. Individual-level measures of socioeconomic status (SES) may be difficult to assess for young women. The authors examined whether neighbourhood SES provides a useful measure in comparison with individual-level SES with respect to the burden of multiple chlamydia diagnoses.

Methods

In a study of young women with chlamydia (n=233; mean age =21 years), multiple infections were assessed with self-report and follow-up testing. General estimating equations and pseudo-R2 were used to assess the roles of individual-level SES (education and employment) and neighbourhood-level SES (percentage of people in census tract of residence below poverty) on multiple chlamydia diagnoses.

Results

Neither education nor employment was associated with multiple chlamydia diagnoses. Women living in high-poverty areas were significantly more likely than those living in low-poverty areas to have multiple chlamydia diagnoses (adjusted OR 3.46, 95% CI 1.18 to 10.15). This neighbourhood-level poverty measure improved model fit by 17%.

Conclusions

Neighborhood-level poverty may provide a better measure of SES than individual-level variables as a predictor of multiple chlamydia diagnoses in young women and can be useful when valid measures of individual-level SES are unavailable.

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