Institute for Global Health and Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA and Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Ann Epidemiol. 2019 Jan;29:67-73.e1. doi: 10.1016/j.annepidem.2018.10.006. Epub 2018 Oct 29.
Voting may play a critical role in the allocation of social and structural resources to communities, which in turn shapes neighborhood environments, and ultimately, an individual's sexually transmitted infection (STI) risk. We assessed relationships among county-level voter turnout and felony voter disenfranchisement, and STIs.
This cross-sectional multilevel analysis included 666 women in Alabama, Florida, Georgia, Mississippi, and North Carolina enrolled in the Women's Interagency HIV Study between 2013 and 2015. Having a baseline bacterial STI (chlamydia, gonorrhea, trichomoniasis, or early syphilis) was determined by laboratory testing. We used generalized estimating equations to test relationships between county-level voter turnout in the 2012 general election, county-level percentage of felony disenfranchised voters, and STI prevalence.
Eleven percent of participants had an STI. Higher voter turnout corresponded to lower STI prevalence (prevalence ratio = 0.84, 95% confidence interval = 0.73-0.96 per 4 percentage point higher turnout). Greater felony voter disenfranchisement corresponded to higher STI prevalence (prevalence ratio = 1.89, 95% confidence interval = 1.10-3.24 per 4 percentage point higher disenfranchisement).
STI prevalence was inversely associated with voter turnout and positively associated with felony voter disenfranchisement. Research should assess causality and mechanisms through which civic engagement shapes sexual health. Expanding political participation, including eliminating discriminatory voting laws, could influence sexual health.
投票可能在将社会和结构性资源分配给社区方面发挥关键作用，而社区环境又会反过来影响个人的性传播感染（STI）风险。我们评估了县一级投票率和重罪选民被剥夺选举权之间的关系，以及与 STI 的关系。
本横断面多水平分析纳入了 2013 年至 2015 年期间参加妇女间艾滋病研究（Women's Interagency HIV Study）的阿拉巴马州、佛罗里达州、佐治亚州、密西西比州和北卡罗来纳州的 666 名女性。通过实验室检测确定基线细菌性 STI（衣原体、淋病、滴虫病或早期梅毒）。我们使用广义估计方程来检验 2012 年大选时县一级投票率、县一级重罪被剥夺选举权者的百分比与 STI 患病率之间的关系。
11%的参与者患有 STI。更高的投票率与更低的 STI 患病率相关（患病率比=0.84，95%置信区间=0.73-0.96，每增加 4 个百分点的投票率）。更高的重罪选民被剥夺选举权与更高的 STI 患病率相关（患病率比=1.89，95%置信区间=1.10-3.24，每增加 4 个百分点的被剥夺选举权）。
STI 患病率与投票率呈负相关，与重罪选民被剥夺选举权呈正相关。研究应评估公民参与对性健康的影响的因果关系和机制。扩大政治参与，包括消除歧视性投票法，可能会影响性健康。
