When the once-booming American auto industry collapsed in the last decades of the twentieth century, southeast Michigan took a huge economic hit — especially in the vast, racially diverse metropolitan areas of Flint and Detroit. Health outcomes and behaviors in the region took a second hit, with unprecedented increases in conditions such as obesity, violence, and sexually transmitted infections (STIs), including HIV.
Today the state of Michigan has the nation’s seventh highest cumulative gonorrhea infection rates and 14th highest cumulative chlamydia infection rates, according to the U.S. Centers for Disease Control and Prevention. The devastating impact of these infections is most keenly felt in the Detroit and Flint metro areas among young men who have sex with men—a population that also suffers disproportionate rates of HIV. When stratified by race and ethnicity, it’s clear that within this group, young black and Latino men who have sex with men bear the brunt of Michigan’s STIs.
How to reduce these disparities? Dr. Jose Bauermeister, the John G. Searle Assistant Professor of Health Behavior and Health Education at the School of Public Health, thinks the solution lies in a community-based approach focused on structural factors.
“We know that these disparities are forcibly molded by dominant structural forces like racism, economic disadvantage, residential segregation, and homophobia,” says Bauermeister, who directs the U-M Center for Sexuality & Health Disparities (SexLab). “And we know that those same forces limit the development of safe spaces where young gay, bisexual, and other men who have sex with men and transgender people can express their sexuality and gender, and find both the support and opportunities they need.”
Bauermeister is lead scientist for a new three-year, one-million dollar project, “Community Approaches to Reducing STIs”—or “MFierce,” as the project’s six-member Youth Advisory Board has dubbed it—aimed at reducing STIs among young gay and bisexual men and transgender women in southeast Michigan. Launched in Detroit last fall in partnership with community members and organizations throughout the region, the CDC-funded project supports the planning, implementation, and evaluation of interdisciplinary interventions aimed at both the treatment and prevention of STIs.
“If we can improve one area of the system, it has the potential to ripple throughout and spark much needed community mobilization and change,” Dr. Bauermeister says.
He and his fellow researchers and community partners have spent the first year of the project working to heighten awareness of the problem as it affects young men and transgender women, to identify new avenues for STI prevention and treatment within this population, and to provide greater access to culturally sensitive services. Bauermeister and his colleagues plan to devote years two and three of the project to the implementation and evaluation of strategies for reducing STI disparities. Ideally, their work will prove effective enough to be adopted nationwide.
Partners for Health
Collaboration is critical to the success of MFierce, the new CDC-funded academic-community partnership aimed at reducing disparities in sexually transmitted infections in southeast Michigan. Here’s a list of partner organizations: