Thomas JC. From slavery to incarceration: social forces affecting the epidemiology of sexually transmitted diseases in the rural South.
Sex Transm Dis 2006;
33:S6-10. [PMID:
16794556 DOI:
10.1097/01.olq.0000221025.17158.26]
[Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The high rates of sexually transmitted diseases (STDs) in the southeastern United States have been shaped by historic and contemporary social forces. More than other regions of the country, the South was defined by slavery, an extremely hierarchical relationship between whites and blacks. Emancipation left much of the racial hierarchy intact with whites as farm owners and blacks as hired workers or sharecroppers. Agricultural policies that favored mechanization caused blacks to leave farm work and move into segregated towns, leading to the advent of the rural ghetto. Post-World War II mass migration, mostly by young men, to the industrial north altered the sex ratio and social capital of the southern towns left behind. The cocaine epidemic of the 1990s, followed by the high incarceration rates of the "War on Drugs," disproportionately affected low-income blacks. Each of these forces led to sexual and care-seeking behaviors that favor transmission of STDs.
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