Date of Conferral

4-28-2025

Date of Award

April 2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Harrison Ndetan

Abstract

Sexually transmitted infections (STIs) are a significant public health (PH) issue in North Carolina (NC) despite efforts to decrease prevalence. Rates are higher in African American (AA) young adults. Studies have investigated STIs, but little is known about the mediating relationship between factors such as the age of first sexual intercourse, sexual abuse, and sexual contact. The purpose of this quantitative study was to assess if the age of first sexual intercourse and sexual contact mediate the relationship between sexual abuse and gonorrhea/chlamydia infections among AA young adults in NC. A secondary data analysis was conducted using the 2019 Youth Risk Behavior Survey data (n=1,064). The study was modeled after the Baron and Benny framework to assess whether age of first sexual intercourse and sexual contacts mediate the relationship between sexual abuse and gonorrhea/chlamydia using multivariable logistic regression. After adjusting for education and gender, there was a statistically significant relationship between sexual abuse and gonorrhea/chlamydia infections, with 157% increased odds of gonorrhea/chlamydia among those who have experienced sexual abuse (Adjusted OR= 2.57, 95% CI [1.84, 3.59], p=<0.001). This relationship was mediated by age of first sexual intercourse as adjusting for that both reduces the magnitude of the effect and eliminated the statistical significance (Adjusted OR= 1.26. 95% CI [0.83, 1.93], p= 0.28) but not by sexual contacts (suggesting that it does not provide a pathway through which the relationship manifests). These findings provide PH professionals with additional considerations in their efforts to help curb the spread of STIs in AA young adults in NC.

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