Rural Adolescents and Young Adults: Chlamydia and Gonorrhea Acquisition
Open Access
- Author:
- Pinto, Casey
- Graduate Program:
- Nursing
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- February 26, 2016
- Committee Members:
- Lorah D Dorn, Dissertation Advisor/Co-Advisor
Lorah D Dorn, Committee Chair/Co-Chair
Susan Jayne Loeb, Committee Member
Vernon Michael Chinchilli, Committee Member
Ping Du, Committee Member - Keywords:
- Adolescents
Young Adults
Chlamydia
Gonorrhea
STD - Abstract:
- Background: Risky sexual behavior is a burgeoning topic in the adolescent and young adult literature, particularly with respect to acquisition of sexually transmitted diseases (STDs). Adolescents and young adults (15-24 years) in the United States have the highest incidence of STDs compared to all other age groups and have been the focus of many preventative measures. However, the focus is on urban populations, thus rural adolescents and young adults remain understudied in the area of risky sexual behavior and STDs. Purpose: The following dissertation is an ecological descriptive study analyzing chlamydia and gonorrhea rates among both rural adolescent (15-19 years) and rural young adult (20-24 years) populations as compared to urban adolescent and young adult populations. Methods: The subsequent study utilized three datasets; the Pennsylvania National Electronic Database Surveillance System (PA-NEDSS), census statistics, and the Pennsylvania Center for Education Statistics National School Lunch Program dataset. This dissertation had two main aims. The first aim provided an overview of current Pennsylvania adolescent and young adult chlamydia and gonorrhea rates, both rural and urban, using negative binomial regressions. The second aim provided an analysis of county level data, both rural and urban, over time using a repeated measures analysis to determine change in the rates of chlamydia and gonorrhea over an 11-year period. Results: This study demonstrated that rates of chlamydia were higher in rural 18-19, 20, and 21-year-old populations for the years 2011 through 2014 as compared to urban populations in Pennsylvania when controlling for poverty and gender. The second outcome demonstrated that among all age groups studied, a significant increase of chlamydia and gonorrhea rates for both males and females were seen in selected counties of PA. While the increase was noted, select counties in both rural and urban settings also had decreases in STD rates. Conclusions: This dissertation provided empirical evidence that STD rates, specifically chlamydia and gonorrhea, are not only higher in rural areas, but have also increased from 2004 until 2014. The results of this study document the need for further research to better understand the societal and behavioral mechanisms of disease acquisition, with special emphasis on primary prevention methods, in particular in rural areas of Pennsylvania in these young age groups.