BACKGROUND The association between county-level social capital indices (SCIs) and the three most commonly reported sexually transmitted infections (STIs) in the United States is lacking. In this study, we determined… Click to show full abstract
BACKGROUND The association between county-level social capital indices (SCIs) and the three most commonly reported sexually transmitted infections (STIs) in the United States is lacking. In this study, we determined and examined the association between two recently developed county-level SCIs (i.e., Penn State social capital index [PSSCI] vs. United States Congress social capital index [USCSCI]) and the three most commonly reported bacterial STIs (chlamydia, gonorrhea and syphilis) using spatial and non-spatial regression techniques. METHODS We assembled and analyzed multi-year (2012-2016) cross-sectional data on STIs and two SCIs (PSSCI vs. USCSCI) on counties in all 48 contiguous states. We explored two non-spatial regression models (univariate and multiple generalized linear models) and three spatial regression models (spatial lag model, spatial error model and the spatial autoregressive moving average model) for comparison. RESULTS Without exception, all the SCIs were negatively associated with all three STI morbidity. A one-unit increase in the SCIs were associated with at least 9% (p<0.001) decrease in each STI. Our test of the magnitude of the estimated associations indicated that the USCSCI was at least two-times higher than the estimates for the PSSCI for all STIs (highest p-value=0.01). CONCLUSIONS Overall, our results highlight the potential benefits of applying/incorporating social capital concepts to STI control and prevention efforts. In addition, our results suggest that for the purpose of planning, designing and implementing effective STI control and prevention interventions/programs, understanding the communities' associational life (as indicated by the factors/data used to develop the USCSCI) may be important.
               
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