Obregon, Misael (2015-08). Extending the Latina Paradox: Comparative Findings of STIs among Mexican-Origin, Black And White Birth-Giving Women. Doctoral Dissertation.
Thesis
This dissertation compares health outcomes in prevalence and likelihood of sexually transmitted infections (STIs) present or treated during pregnancy among Mexican-origin, Non-Hispanic White and Black birth-giving populations. Comparative analyses are done for years 2009-2012 using birth certificate records from the National Center for Health Statistics (NCHS). The study employs the use of t-test (mean) comparisons to determine significant differences in prevalence of STIs present or treated during pregnancy between race and ethnic groups. To determine the likelihood of presence or treatment of STI during pregnancy, a logistic regression model is employed. Descriptive results from the analyses show as anticipated that Mexican-origin women have the lowest levels of socioeconomic status (SES), as measured by education attainment. Given the inverse correlation of SES and STIs, it is expected that Mexican-origin women would have higher prevalence and likelihood of presence or treatment of STIs. Results of the study show that prevalence of STIs is indeed significantly higher for Mexican-origin and Black women than their White birth-giving counterparts. However, predictive logistic regression models estimate that the likelihood of presence or treatment of an STI is unexpectedly higher for Whites and Blacks when compared to their Mexican-origin counterparts. These unanticipated results are not unique and parallel other health advantages found among Latinas as have been detailed within the Latina paradox. Results of this dissertation show support for future research that have implications to extend the breadth of the Latina paradox to include STIs. This is the case at least in regards to birth-giving women in the US. Additional significant findings show that, in relation to prenatal care, women deferring their first prenatal visit during the last trimester of their pregnancy had the highest odds of having an STI present or treated during pregnancy. Findings for this dissertation provide policy implications for preconception and interconception maternal health. In addition, findings provide support for the continual promotion of STI screenings at first prenatal visit and implementation of preventive practice/medicine targeting underserved populations such as those women deferring their first prenatal visit at the third trimester.
