School suspension predicts trichomoniasis five years later in a matched sample

Area of Science:

• Public Health
• Adolescent Health
• Epidemiology

Background:

• Adolescent school suspension is associated with increased risk of arrest, probation, and high school non-graduation, all known risk factors for sexually transmitted infections (STIs).
• This study investigates whether school suspension serves as an independent marker for STI risk among young adults who otherwise avoid negative post-suspension outcomes.

Purpose of the Study:

• To determine if adolescent school suspension predicts STI diagnosis in young adulthood.
• To identify potential mediating factors in the relationship between school suspension and STI risk.

Main Methods:

• Utilized matched sampling from the National Longitudinal Study of Adolescent and Adult Health (Add Health) to compare 381 first-time suspended youth with 980 non-suspended peers.
• Employed Mahalanobis and exact matching within propensity score calipers, ensuring similarity across 67 pre-suspension variables.
• Assessed STI outcomes (chlamydia, gonorrhea, trichomoniasis) via urine tests 5 years post-suspension and conducted causal mediation analysis.

Main Results:

• Suspended youth showed a significantly higher likelihood of testing positive for trichomoniasis 5 years after suspension compared to matched non-suspended peers (OR=2.87).
• Pre-suspension household income below the median partially explained the association between suspension and trichomoniasis, accounting for 9% of the effect.
• Criminal justice involvement and educational attainment were not statistically significant mediators in this relationship.

Conclusions:

• School suspension acts as a significant marker for increased STI risk in young adulthood.
• The punitive nature of suspension may lead adolescents into riskier sexual networks, irrespective of subsequent educational or legal outcomes.
• Suspension can exacerbate existing socioeconomic disadvantages, particularly for low-income youth, by limiting resources for recovery and increasing vulnerability to negative health outcomes like STIs.