{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T20:48:51Z","timestamp":1763498931276},"reference-count":19,"publisher":"American Public Health Association","issue":"8_Pt_1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[1995,8]]},"abstract":"<jats:p> We studied primary and secondary syphilis rates in North Carolina for 1985 through 1993 to elucidate demographic trends and the role of rurality in the state's high rates. Each of the state's 100 counties was classified by rural-urban character; and county-level rates, adjusted for gender, race, and age group, were compared. Syphilis rates rose dramatically during the 9-year period, with most of the increase occurring among women, non-Whites, and rural counties. The rural rates recently surpassed urban rates, with the greatest increase experienced by non-White rural women. The exchange of sex for drugs and characteristics of rural poverty may be fueling these trends. <\/jats:p>","DOI":"10.2105\/ajph.85.8_pt_1.1119","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T13:18:52Z","timestamp":1227964732000},"page":"1119-1122","source":"Crossref","is-referenced-by-count":36,"title":["Syphilis in the South: rural rates surpass urban rates in North Carolina."],"prefix":"10.2105","volume":"85","author":[{"given":"J C","family":"Thomas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A L","family":"Kulik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"V J","family":"Schoenbach","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"844","reference":[{"key":"p_1","unstructured":"StatisticalAbstract of the United States, 1993. 113th ed. Washington, DC: US Dept of Commerce, Bureau of the Census; 1993."},{"key":"p_2","unstructured":"Jones JH. Bad Blood New York: Free Press; 1981. Transmitted Disease Surveilance, 1992. At"},{"key":"p_3","unstructured":"Division of STD\/HIV Prevention. Sexualy lanta, Ga: Centers for Disease Control and Prevention; July 1993."},{"key":"p_4","unstructured":"North Carolina Rural Profile. Economic and lina. Raleigh, NC: The North Carolina Social Trends Affecting Rural North Caro-Rural Economic Development Center; November 1992."},{"key":"p_5","doi-asserted-by":"crossref","unstructured":"Rolfs RT, Nakashima AK Epidemiology of primary and secondary syphilis in the United States, 1981 through 1989. JAM.4. 1990;264:1432-1437.","DOI":"10.1001\/jama.264.11.1432"},{"key":"p_6","unstructured":"Nakashima AK, Rolfs RT, Ladan Al. Trends in the rural and urban distribution of primary and secondary syphilis, United States, 1986-90. Presented at the annual meeting of the International Society for Sexually Transmitted Disease Research; October 7,1991; Banff, Canada."},{"key":"p_8","doi-asserted-by":"crossref","unstructured":"Wasserheit JW. Epidemiological synergy: interrelationships between HIV infection and other STDs. In: Chen LC, Amor JS-I, Segal SJ, eds. AIDS and Women's Reproductive Health. New York, NY: Plenum Press; 1991:47-72.","DOI":"10.1007\/978-1-4615-3354-2_6"},{"key":"p_9","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1991.03470170075027"},{"key":"p_11","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199111000-00015"},{"key":"p_12","first-page":"35","volume":"37","year":"1988","journal-title":"Continuing States. 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In: Volberding P, Jacobson MA, eds. AIDS Clinical Review, 1990. New York, NY: Marcel Dekker Inc; 1993:25-62."},{"key":"p_20","unstructured":"Klimko T. Congenital syphilis in North Carolina. Epi Notes [North Carolina Department of Environment, Health, and Natural Resources]. 1992;6:1-2."},{"key":"p_21","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19930801)72:3+<1113::AID-CNCR2820721328>3.0.CO;2-A"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.85.8_Pt_1.1119","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T21:26:41Z","timestamp":1652131601000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.85.8_Pt_1.1119"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,8]]},"references-count":19,"journal-issue":{"issue":"8_Pt_1","published-print":{"date-parts":[[1995,8]]}},"alternative-id":["10.2105\/AJPH.85.8_Pt_1.1119"],"URL":"https:\/\/doi.org\/10.2105\/ajph.85.8_pt_1.1119","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[1995,8]]}}}