| Titre : | The social ecology of syphilis. (1999) |
| Auteurs : | J.C. Thomas ; M. CLARK ; P.H. KILMARX ; M. MONNETT ; T.A. PETERMAN ; J. ROBINSON ; Department of Epidemiology. Chapel Hill. NC. USA ; National Center for Hiv. Std and Tb Prevention. Centers for Disease Control and Prevention. Atlanta. GA. USA |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 48, n° 8, 1999) |
| Pagination : | 1081-1094 |
| Langues: | Anglais |
| Mots-clés : | Syphilis ; Bactériose ; Infection ; Epidémiologie ; Facteur risque ; Homme ; Prévention santé ; Etats Unis ; Amérique ; Maladie sexuellement transmissible ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST 4R0xEAU5. Diffusion soumise à autorisation]. Factors affecting the transmission of syphilis can be categorized into those acting at the level of individuals (e.g., number of sex partners) and others at the level of the sociophysical environment (e.g., availability of treatment services for curable infections). In a prior study, we identified several sociophysical factors correlated with the ten-year mean syphilis rate in a regression analysis of United States counties. In the present study we used qualitative methods to investigate additional aspects of some factors in the regression, as well as to identify entirely new factors. Twelve counties with populations less than 100,000 and ten-year mean syphilis rates that were greater or less than expected by the regression model were selected for a three to five day visit. The case study protocol included observations, unstructured interviews with care providers and county residents, and a standardized questionnaire completed by state and local sexually transmitted disease control personnel pertaining to characteristics and practices of the local health department. Comparisons of the field notes and questionnaires revealed patterns of factors of the sociophysical environment that potentially affect county syphilis rates. These included access to the health department STD clinic, race relations, employment opportunities for minorities, interagency coordination, STD outreach activities, the social acceptability of discussing STDs, and intercommunity dynamics. (...) |
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