EDITORIAL

Social epidemiology

Understanding racial-ethnic and societal differentials in STI

S O Aral

Centers for Disease Control and Prevention, National Center for HIV, STD and TB Prevention, Division of STD Prevention, Atlanta, GA, USA

Correspondence to:
Correspondence to:
Division of STD Prevention, CDC, 1600 Clifton Road, NE, M/S-E02, Atlanta, GA 30333, USA;
pbj9@cdc.gov

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Do we need to move beyond behavioural epidemiology?

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Keywords: social epidemiology; sexually transmitted infections; social networks

Prevalence and incidence of sexually transmitted infections (STIs) vary across societies¹ and across subpopulations defined by age, race-ethnicity, and socioeconomic status.^{2, 3} The efforts to account for such variation and explain it, that can be found in the STD literature, have in general not differentiated between individual and population level health, or between population and individual level determinants of individual STD outcomes.⁴ Perhaps this pattern reflects the predominant paradigm in modern epidemiology which has been termed the "risk factor" paradigm and has been linked to "biomedical individualism" as its underlying theoretical foundation.^{5, 6} This theoretical approach views populations simply as reflective of individual cases while considering social determinants of disease to be at best secondary, if not irrelevant.⁷ In the past several years, the risk factor paradigm in epidemiology has been seriously challenged by leading epidemiologists ^{8, 9} and a new paradigm that would emphasise the broader context of individual risk factors . . . [Full text of this article]

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This article has been cited by other articles:

• Aral, S. O, Lipshutz, J., Blanchard, J. (2007). Drivers of STD/HIV epidemiology and the timing and targets of STD/HIV prevention. Sex. Transm. Infect. 83: i1-i4 [Full Text]  
• Poundstone, K. E., Strathdee, S. A., Celentano, D. D. (2004). The Social Epidemiology of Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome. Epidemiol Rev 26: 22-35 [Full Text]  
• Aral, S O, Blanchard, J F (2002). Phase specific approaches to the epidemiology and prevention of sexually transmitted diseases. Sex. Transm. Infect. 78: i1-2 [Full Text]