All ETDs from UAB

Advisory Committee Chair

Lonnie Hannon, Iii

Advisory Committee Members

Faith Fletcher

Antonio J Gardner

Gregory Pavela

Tamika Smith

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


Introduction: Syphilis is a sexually transmitted infection (STI) that can cause serious health problems, including neurological disorders, blindness, and fetal abnormalities. Routine STI screenings can help prevent its spread. Despite effective treatments, syphilis cases have risen sharply in the last decade, particularly among marginalized communities. Understanding the ecological and contextual factors contributing to syphilis incidence could inform prevention efforts and improve healthcare outcomes for all. Methods: Retrospective secondary data analyses, at the county level, from 2020 to 2022, were conducted to assess for mean differences among social vulnerability index (SVI) scores, SVI scores by four primary categories, Black Belt regional status, and secondary syphilis among African American people in Alabama. Secondary data analysis was also done to compute the strength of relationships between the ratio of African American service-providing medical professionals per county to the overall African American population per county and secondary syphilis incidence among African Americans in Alabama. Results: The following variables were found to have moderate influences on secondary syphilis case incidence among the 67 counties in Alabama between 2020 – 2022: 1) Overall SVI, 2) SVI associated with racial and ethnic minority status, 3) SVI associated with household and transportation type, and 4) population density. Conclusion: Study findings support the need to understand the root causes of syphilis infection transmission more deeply. By pinpointing the specific social, economic, and cultural factors that make people more vulnerable to syphilis transmission, we can develop more effective interventions that significantly reduce the number of syphilis cases and improve the sexual health and well-being of underserved communities nationally.

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