Youth Voices on the Sexually Transmitted Infection Risk Environment: Community Violence, Chronic Trauma, and Sexual Health Outcomes

What Is the Purpose of this Study?

• • This study engaged youth and adults working with youth in two neighborhoods of Baltimore, Maryland, with high sexually transmitted infection (STI) rates to:

  1. 1. Explore how youth and adults working with youth perceive their community environment to influence STI risk, and

  2. 2. Gather information about what youth and adults working with youth prioritize as key social determinants of STIs in their communities.

What Is the Problem?

• • Reported STIs reached an all-time high in 2015, with young people (ages 15–24) disproportionately affected.

• • Social determinants, including economic, social, and physical factors at the community level, have been identified as important in shaping risk for STI acquisition and transmission and STI inequities.

• • There remains a need to engage affected communities and to identify what community members prioritize as primary social determinants influencing STIs in their communities.

• • Given the high rates of STIs among young people, their engagement in identifying and prioritizing key social determinants is critical.

What Are the Findings?

• • Youth and adults working with youth recognized and prioritized the role of chronic trauma in shaping sexual health outcomes of young community members.

• • In this context of chronic trauma, young people prioritize immediate concerns with daily life and survival in their impoverished and violent communities over concerns about STIs, and describe using sex as a mechanism for coping in the absence of mental health and emotional support.

Who Should Care Most?

• • Policy makers in urban settings.

• • Adults working with youth in or from impoverished, urban settings.

• • Researchers studying STI disparities among young people.

Recommendations for Action

• • Interventions aiming to reduce STIs among young people should provide services in a trauma-sensitive framework and include linkage to mental health resources.

• • Structural interventions (i.e., interventions aimed at addressing social determinants, rather than individual health behaviors) are needed to reduce STI inequities experienced by young people.

• • Health-in-All-Policies may facilitate the formulation and adoption of structural interventions that contribute to STI prevention.