Socioeconomic Status (SES) and STD Risk

It may be surprising to hear that having low socioeconomic status reduces a person's access to healthcare which, in turn, negatively impacts their health. This includes their sexual health and their vulnerability to any number of sexually transmitted infections (STIs), including HIV.

Having a low socioeconomic status not only influences how, when, and if an STI gets treated, but it also increases a person's risk of getting an STI—in part because the infection is not being controlled within their community.

This article defines socioeconomic status and how it impacts a person's health directly and indirectly. It also looks at the association between socioeconomic status and a person's risk of STIs.

What Is Socioeconomic Status?

Socioeconomic status (SES) is the measure of a person's economic and social position in relation to others in society based on income, education, and occupation. SES is typically broken into three levels—high, middle, and low—to describe the place in society an individual or family may fall into in relation to others.

In recent years, SES has been used to describe the impact of economic inequality on the health of different populations. This not only includes the rate at which a person accesses treatment based on their SES, but also the level at which SES affects the incidence of diseases in different groups.

While having a high, middle, or low SES may seem synonymous with having a high, middle, or low income, it is not necessarily so. SES involves not only income but also educational attainment, financial security, and subjective perceptions of social status and social class.

It is these latter two distinctions—social status and social class—that can influence health outcomes as much as how much money a person makes. This is especially true when it comes to the issue of race and ethnicity.

On the one hand, race and ethnicity greatly influence a person's SES in the United States. On the other, race and ethnicity influence how people of the same SES are treated, including their access to healthcare and how public health policies are formed.

In the United States, the association between SES and race/ethnicity is intimately linked.

SES and STIs

There is a clear association between low SES and the risk of getting an STI. This is especially true among adolescents, teens, and young adults who are more sexually active.

A 2013 study published in Sexually Transmitted Diseases evaluated the risk of STIs (specifically chlamydia, gonorrhea, and trichomoniasis) among young adults 18 to 26 based on their socioeconomic status. The study was conducted as part of an ongoing national survey started in the 1990s which tracked the health of adolescents through adulthood.

Not surprisingly, they found that the rate of STIs increased as SES deceased. However, a far bigger factor was the rate of STIs among people of different racial or ethnic groups. In all categories of income, Black people were at two to three times greater risk of STIs than White people of the same SES.

By contrast, only Latinx people categorized as poor, 2nd poorest, and middle had significantly higher rates of STIs compared to White people.

The explanation for the disparity is complex. Purely from the perspective of SES (independent of race/ethnicity), the researchers suggest that several factors are at play, including:

• Less access to healthcare
• Less access to preventative information
  
• Increased odds of infection due to higher community STI rates
• Using sex for economic purposes

An entirely different picture develops when looking at STI risk among people of the same racial or ethnic group.

According to the study, the risk of chlamydia, gonorrhea, or trichomoniasis among different SES groups of the same race or ethnicity varied by only 5% to 15%—far less than what was seen when comparing different racial or ethnic groups with the same SES.

Summary

Socioeconomic status (SES)—based on income, education, and occupation—is closely linked to a person's risk of STIs. People with lower SES tend to be at greater risk than people with higher SES due to inequalities in healthcare and other factors.

A person's race or ethnicity also factors into how likely they are to get an STI. On the one hand, a Black person is two to three times more likely to get an STI than a White person of the same SES. On the other, the risk among people of the same racial or ethnic group will also vary by SES but not as consistently or dramatically.

A Word From Verywell

Improving access to healthcare can have profound effects on leveling the playing field and reducing the impact of SES on health. This not only means better insurance coverage but aslo the ability to access quality healthcare in neighborhoods and communities.

From an individual standpoint, being at risk of STIs due to your economic status does not mean you will get an STI. To avoid infection, the same rules apply no matter how rich or poor you are.

To lower your risk, use condoms consistently, reduce your number of sex partners, and speak with your healthcare provider about recommended STI screenings if you are sexually active.