A Systematic Review Exploring Racial Disparities,Social Determinants of Health,and Sexually Transmitted Infections in Black Women

ObjectiveTo explore and describe racial disparities, the role of social determinants of health, and individual risk behaviors among Black women as related to sexual health and/or sexually transmitted infections (STIs).Data SourcesElectronic resource databases used were PubMed, CINAHL, and Google Scholar. Peer-reviewed articles published during 2010 to 2020 were considered.Study SelectionThirty-two studies met the criteria and included data for a total of 18,904 Black women.Data ExtractionData were extracted from each study using the subheadings author (year), purpose, design, sample demographics and setting, key measures, key findings, and quality assessment. In addition, PRISMA-E and PROGRESS-Plus guided data extraction to illustrate health inequity.Data SynthesisBlack women who were more likely to report having an STI over the course of their lifetime engaged in behaviors associated with greater risk, the most common of which were unprotected sex, disproportionate partner power, and substance abuse. The primary social determinants of health associated with increased risk were lower income and lower levels of education. Black women were less likely to discuss or feel comfortable discussing their sexual health with health care providers. By contrast, engagement in safe sexual practices stemmed from internal, social, and relationship factors.ConclusionIdentifying Black women who are at risk of contracting an STI is essential in driving clinical decision-making. Health care providers should be cognizant of the long-standing mistrust that Black women have of health care providers and, therefore, work to establish positive respectful and trusting relationships with open communication.