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Residential racial segregation and racial differences in sexual behaviours: an 11-year longitudinal study of sexual risk of adolescents transitioning to adulthood
  1. Katie Brooks Biello1,2,
  2. Linda Niccolai3,
  3. Trace S Kershaw3,
  4. Haiqun Lin3,
  5. Jeannette Ickovics3
  1. 1Fenway Institute, Fenway Health, Boston, Massachusetts, USA
  2. 2Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
  3. 3School of Epidemiology and Public Health, Yale University, New Haven, Connecticut, USA
  1. Correspondence to Dr Katie Brooks Biello, 1340 Boylston Street, Boston, MA 02215, USA; kbiello{at}


Background Determining the underlying causes of racial disparities in sexually transmitted infections (STIs) is important. In the USA, rates of the most common STIs range from 5 to 20 times higher for African–Americans compared to Caucasians, and the health consequences of STIs can be serious. Residential racial segregation results in very different contexts for individuals and may be an important determinant of sexual risk. The purpose of this study was to examine how segregation and race interact to impact the age trajectory of sexual risk behaviours.

Methods Using 11 years of data from the National Longitudinal Survey of Youth 1997 (1997–2007) and 2000 Census data, the authors performed three-level hierarchical linear regression to examine the associations between hypersegregation, race and a sexual risk behaviour index among black and white non-Hispanic adolescents as they transition to adulthood.

Results Through most of the teenage years, African–Americans are at higher sexual risk than Caucasians. However, by age 19, Caucasians are at higher risk. Hypersegregation was not associated with increased sexual risk index score on average and did not impact the trajectory of the race–sexual risk association.

Conclusions The authors did not find any evidence that hypersegregation was associated with the sex risk index or that it modified the race–sex risk association as individuals got older. Future studies should examine whether segregation is associated with other causes of STI/HIV acquisition risk, such as sexual network patterns.

  • Sexual risk
  • race
  • health disparities
  • segregation
  • adolescents
  • adolescents CG
  • sexual health
  • geography
  • inequalities
  • multilevel modelling

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  • Funding This work was supported by the National Institute of Mental Health at the National Institutes of Health (T32MH020031 and P30MH062294). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Yale University Human Subjects Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.