{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T22:50:39Z","timestamp":1761519039263,"version":"build-2065373602"},"reference-count":22,"publisher":"CSIRO Publishing","issue":"4","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":4858,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,8,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the United States, sexually transmissible infection (STI) and family planning (FP) clinics play a major role in the detection and treatment of STIs. However, an examination of the spatial distribution of these service sites and their association with STI morbidity and county-level socioeconomic characteristics is lacking. We demonstrate how mapping and regression methods can be used to assess the spatial gaps between STI services and morbidity. Methods: We used 2007 county-level surveillance data on chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and syphilis. The geocoded STI service (STI or FP clinic) locations overlaid on the Texas county-level chlamydia, gonorrhoea and syphilis morbidity map indicated that counties with high incidence had at least one STI service site. Logistic regression was used to examine the association between having STI services and county-level socioeconomic characteristics. Results: Twenty-two percent of chlamydia high-morbidity counties (&amp;gt;365 out of 100 000); 32% of gonorrhoea high-morbidity counties (&amp;gt;136 out of 100 000) and 23% of syphilis high-morbidity counties (\u22654 out of 100 000 and at least two cases) had no STI services. When we controlled for socioeconomic characteristics, high-morbidity syphilis was weakly associated with having STI services. The percent of the population aged 15\u201324 years, the percent of Hispanic population, the crime rate and population density were significantly (P &amp;lt; 0.05) associated with having STI services. Conclusion: Our results suggest that having an STI service was not associated with high morbidity. The methods used have demonstrated the utility of mapping to assess the spatial gaps that exist between STI services and demand.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh11117","type":"journal-article","created":{"date-parts":[[2012,8,10]],"date-time":"2012-08-10T00:42:52Z","timestamp":1344559372000},"page":"334-340","source":"Crossref","is-referenced-by-count":7,"title":["Assessing spatial gaps in sexually transmissible infection services and morbidity: an illustration with Texas county-level data from 2007"],"prefix":"10.1071","volume":"9","author":[{"given":"Kwame","family":"Owusu-Edusei","sequence":"first","affiliation":[{"name":"ADivision of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA."},{"name":"BCorresponding author. Email: Kowusuedusei@cdc.gov"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonal R.","family":"Doshi","sequence":"additional","affiliation":[{"name":"ADivision of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2012,5,11]]},"reference":[{"key":"2025102617024930700_R1"},{"issue":"4","key":"2025102617024930700_R2","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1177\/106286060401900403","article-title":"Sexually transmitted diseases and managed care: an inquiry and review of issues affecting service delivery.","volume":"19","author":"Chorba","year":"2004","journal-title":"Am J Med Qual"},{"issue":"4","key":"2025102617024930700_R3","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1097\/OLQ.0b013e3181d5e01e","article-title":"Improving clinical operations: can we and should we save our STD clinics?","volume":"37","author":"Golden","year":"2010","journal-title":"Sex Transm Dis"},{"issue":"10","key":"2025102617024930700_R4","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1097\/OLQ.0b013e3182215615","article-title":"County-level sexually transmitted disease detection and control in Texas: do sexually transmitted diseases and family planning clinics matter?","volume":"38","author":"Owusu-Edusei","year":"2011","journal-title":"Sex Transm Dis"},{"issue":"3","key":"2025102617024930700_R5","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1097\/OLQ.0b013e31815c1edb","article-title":"Mapping the core: chlamydia and gonorrhea infections in Calgary, Alberta.","volume":"35","author":"Bush","year":"2008","journal-title":"Sex Transm Dis"},{"issue":"6","key":"2025102617024930700_R6","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.2105\/AJPH.2009.172965","article-title":"Socioeconomic gradients in sexually transmitted diseases: a geographic information system-based analysis of poverty, race\/ethnicity, and gonorrhea rates in California, 2004\u20132006.","volume":"100","author":"Springer","year":"2010","journal-title":"Am J Public Health"},{"issue":"4","key":"2025102617024930700_R7","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1136\/sti.2003.006700","article-title":"Spatial analysis and mapping of sexually transmitted diseases to optimise intervention and prevention strategies.","volume":"80","author":"Law","year":"2004","journal-title":"Sex Transm Infect"},{"issue":"1","key":"2025102617024930700_R8","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1186\/1476-072X-8-12","article-title":"Monitoring county-level chlamydia incidence in Texas, 2004\u20132005: application of empirical Bayesian smoothing and Exploratory Spatial Data Analysis (ESDA) methods.","volume":"8","author":"Owusu-Edusei","year":"2009","journal-title":"Int J Health Geogr"},{"issue":"6","key":"2025102617024930700_R9","doi-asserted-by":"publisher","first-page":"1519","DOI":"10.1086\/516491","article-title":"An investigation of geographic clustering of repeat cases of gonorrhea and chlamydial infection in San Francisco, 1989\u20131993: evidence for core groups.","volume":"175","author":"Ellen","year":"1997","journal-title":"J Infect Dis"},{"issue":"7","key":"2025102617024930700_R10","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/oxfordjournals.aje.a009513","article-title":"Geographic epidemiology of gonorrhea in Baltimore, Maryland, using a geographic information system.","volume":"147","author":"Becker","year":"1998","journal-title":"Am J Epidemiol"},{"issue":"7","key":"2025102617024930700_R11","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1097\/00007435-199808000-00011","article-title":"Gonorrhea in the United States, 1981\u20131996 \u2013 demographic and geographic trends.","volume":"25","author":"Fox","year":"1998","journal-title":"Sex Transm Dis"},{"issue":"2","key":"2025102617024930700_R12","doi-asserted-by":"publisher","first-page":"S22","DOI":"10.1097\/OLQ.0b013e31815ed7c8","article-title":"Is jail screening associated with a decrease in chlamydia positivity among females seeking health services at community clinics? San Francisco, 1997\u20132004.","volume":"36","author":"Barry","year":"2009","journal-title":"Sex Transm Dis"},{"key":"2025102617024930700_R13","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1186\/1471-2334-10-275","article-title":"The spatial context of clinic-reported sexually transmitted infection in Hong Kong.","volume":"10","author":"Lee","year":"2010","journal-title":"BMC Infect Dis"},{"issue":"3","key":"2025102617024930700_R14","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1071\/SH08026","article-title":"Accessibility and acceptability of public sexual health clinics for adult clients in New South Wales, Australia.","volume":"5","author":"Ramanathan","year":"2008","journal-title":"Sex Health"},{"key":"2025102617024930700_R15"},{"key":"2025102617024930700_R16","unstructured":"Texas Department of State Health Services (TDoSHS). Family planning clinic locator. Austin: TDOSHS;2009. Available online at: http:\/\/www.dshs.state.tx.us\/famplan\/locator.shtm [verified August 2009]"},{"key":"2025102617024930700_R17"},{"issue":"12","key":"2025102617024930700_R18","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1097\/00007435-200212000-00012","article-title":"Gonorrhea surveillance: the missing links.","volume":"29","author":"Rothenberg","year":"2002","journal-title":"Sex Transm Dis"},{"key":"2025102617024930700_R19"},{"issue":"10","key":"2025102617024930700_R20","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1097\/OLQ.0b013e3181b6ac93","article-title":"Using spatial regression methods to examine the association between county-level racial\/ethnic composition and reported cases of chlamydia and gonorrhea: an illustration with data from the state of Texas.","volume":"36","author":"Owusu-Edusei","year":"2009","journal-title":"Sex Transm Dis"},{"issue":"10","key":"2025102617024930700_R21","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1097\/00007435-199711000-00009","article-title":"Patients attending STD clinics in an evolving health care environment. Demographics, insurance coverage, preferences for STD services, and STD morbidity.","volume":"24","author":"Celum","year":"1997","journal-title":"Sex Transm Dis"},{"key":"2025102617024930700_R22","doi-asserted-by":"publisher","first-page":"S19","DOI":"10.1097\/OLQ.0b013e31818f2ae1","article-title":"Access to care issues for African American communities: implications for STD disparities.","volume":"35","author":"Parrish","year":"2008","journal-title":"Sex Transm Dis"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/9\/4\/334\/1254034\/sh11117.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/9\/4\/334\/1254034\/sh11117.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T21:02:52Z","timestamp":1761512572000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/9\/4\/334\/184764\/Assessing-spatial-gaps-in-sexually-transmissible"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,5,11]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,8,10]]}},"URL":"https:\/\/doi.org\/10.1071\/sh11117","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"type":"print","value":"1448-5028"},{"type":"electronic","value":"1449-8987"}],"subject":[],"published":{"date-parts":[[2012,5,11]]}}}