Thomas James C
Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina 27599-7435, USA.
Sex Transm Dis. 2006 Jul;33(7 Suppl):S6-10. doi: 10.1097/01.olq.0000221025.17158.26.
The high rates of sexually transmitted diseases (STDs) in the southeastern United States have been shaped by historic and contemporary social forces. More than other regions of the country, the South was defined by slavery, an extremely hierarchical relationship between whites and blacks. Emancipation left much of the racial hierarchy intact with whites as farm owners and blacks as hired workers or sharecroppers. Agricultural policies that favored mechanization caused blacks to leave farm work and move into segregated towns, leading to the advent of the rural ghetto. Post-World War II mass migration, mostly by young men, to the industrial north altered the sex ratio and social capital of the southern towns left behind. The cocaine epidemic of the 1990s, followed by the high incarceration rates of the "War on Drugs," disproportionately affected low-income blacks. Each of these forces led to sexual and care-seeking behaviors that favor transmission of STDs.
美国东南部性传播疾病（STD）的高发病率是由历史和当代社会力量所塑造的。与美国其他地区相比，南方地区的特点是奴隶制，即白人和黑人之间存在着极端的等级关系。解放后，许多种族等级制度依然存在，白人是农场主，黑人是雇工或佃农。有利于机械化的农业政策导致黑人离开农场工作，搬到种族隔离的城镇，从而出现了农村贫民窟。二战后的大规模移民，主要是年轻男性向北方工业地区的迁移，改变了南方留守城镇的性别比例和社会资本。20世纪90年代的可卡因泛滥，以及随后“毒品战争”导致的高监禁率，对低收入黑人产生了不成比例的影响。这些力量中的每一种都导致了有利于性传播疾病传播的性行为和寻求医疗行为。
