Social forces and STDs

  • My research integrates epidemiology with methods from other disciplines such as anthropology, sociology, history, molecular biology, medical geography, and health services.

  • I have studied populations in the United States and Africa, but my principal focus has been on rural communities in the American southeast.

  • My research has included the implementation and evaluation of a community-based intervention to prevent STDs that was built on the social assets of a low income, African-American, rural community.

  • The tremendous racial disparities in STDs in the US and international disparities in HIV have been a driving force behind my interest in public health ethics.

  • One of my principal interests is in the community health effects of high rates of incarceration. Because of my work in this area I was featured in an ABC Primetime television special called Out of Control: AIDS in Black America (2006) and a documentary film to be released in 2008 entitled Serial Passage: AIDS, Race, and Culture.

Current projects related to social forces

  • I have finished data collection and am writing the results on a study of networks of agencies that engage in some aspect of HIV prevention. This study has two principal objectives: (1) to develop a county-level measure of interagency coordination for HIV prevention that can be used in multi-county epidemiologic studies; and (2) to generate hypotheses about the relation of network characteristics to racial disparities in STD rates.

  • I have finished data collection and am writing the results of a study of the community health effects of high rates of incarceration in Guilford County, North Carolina.

  • I am currently seeking funding for research on networks of HIV treatment agencies in South Africa.

Selected publications

Social forces

Thomas JC, Levandowski B, Torrone E, Isler MR. The effects of incarceration on neighborhood rates of STDs in Durham, North Carolina. J Urban Health (in press).

Thomas JC, Torrone E, Levandowski B, Isler M. Pulling together: Interagency coordination for HIV prevention in ten North Carolina counties. J Public Health Management and Practice (in press).

Thomas JC, Isler MR, Carter C, Torrone E. An interagency network perspective on HIV prevention. STD 2007;34(2):71-5.

Thomas JC, Torrone E. Incarceration as forced migration: Selected community health effects. Am J Public Health 2006;96:1762-5.

Jackson LE, Hilborn ED, Thomas JC. Towards landscape design guidelines for reducing Lyme disease risk. Int J Epidem 2006;35:315-22.

Thomas JC. From slavery to incarceration: Social forces affecting the epidemiology of STDs in the rural South. STD 2006;33(7 Suppl):S6-10.

Baez DV, Thomas JC, Gomez MA, et al. AIDS trends in Puerto Rico, 1992-2000. Pan Am J Public Health 2005;2:92-101.

Thomas JC, Sampson L. Incarceration as a social force affecting STD rates. Rev Infectious Disease 2005;191:S55-S60.

Thomas JC, Gaffield ME. Social Structure, race, and gonorrhea rates in the southeastern United States. Ethnicity and Disease 2003;13:362-8.

Thomas JC, Thomas K. Things Ain't What They Ought to Be: Social Forces Underlying High Rates of Sexually Transmitted Diseases in a Rural North Carolina County. Social Science & Medicine 1999;49:1075-84.44.

Cook RL, Royce RA, Thomas JC, Hanusa BH. What's driving an epidemic? The spread of syphilis in rural North Carolina along an interstate highway. Am J Public Health 1999; 89:369-73.

Thomas JC, Clark M, Robinson J, Monnett M, Kilmarx PH, Peterman TA. The social ecology of syphilis. Social Science & Medicine 1999;48:1081-1094.

Kilmarx PH, Zaidi AA, Thomas JC, Nakashima AK, St. Louis ME, Flock ML, and Peterman TA. Ecologic analysis of socio-demographic factors and the variation in syphilis rates among counties in the United States, 1984-93. Am J Public Health 1997;87:1937-43 .

Thomas JC, Schoenbach VJ, Eng G, McDonald MA. Rural gonorrhea in the southeastern United States: a neglected epidemic? Am J Epidemiol 1996;143:269-77.

Thomas JC, Kulik A, Schoenbach VS, Weiner D. Syphilis in the South: rural rates surpass urban rates in North Carolina. Am J Public Health 1995;85:1119-22.


Community-based Intervention

Baez-Feliciano DV, Thomas JC, Gomez MA, et al. Changes in the AIDS epidemiologic situation in Puerto Rico following health care reform and the introduction of HAART. Pan American J Public Health 2005;2:92-101.

Thomas JC, Eng E, Ackerman S, Earp JA, Ellis H, Carpenter C. Establishing collaborations that engender trust in the prevention of STDs. In: Roberts AR and Yeager K. Desk Reference on Evidence-Based Practice Research in Healthcare and Human Services. New York, Oxford University Press, 2003.

Thomas JC, Eng E, Earp JA, Ellis H. Trust and collaboration in the prevention of sexually transmitted diseases. Public Health Reports 2001;116:540-7.

Thomas JC, Earp JA, Eng E. Evaluation and lessons learned from a lay health advisor program to prevent sexually transmitted diseases. Int J STD AIDS 2000;11:812-8.

Blumenthal C, Eng E, Thomas JC. STEP sisters, sex, and STDs: A process evaluation of the recruitment of lay health advisors. Am J Health Promotion 1999;14:4-6.

Thomas JC, Eng E, Clark M, Robinson J, Blumenthal C. Lay Health Advisors: Sexually transmitted disease prevention through community involvement. Am J Public Health 1998;88:1252-3.


STD-related behaviors

Mayor AM, Fernández DM, Colón HM, Thomas JC, Hunter-Mellado RF. The acceptability of a multimedia hepatitis C prevention program for Hispanic HIV infected individuals. Ethnicity & Disease (in press).

Torrone E, Thomas JC, Leone P, McCoy SI, Hightow LB. Late diagnosis of HIV in young men in North Carolina. STD (in press).

Mayor AM, Gomez MA, Fernandez DM, Rios-Olivares E, Thomas JC, Hunter RF. Morbidity and mortality profile of HIV-infected patients, with and without hepatitis C co-infection. Am J Trop Med Hygiene 2006;74:239-45.

McDonald MA, Thomas JC, Eng E. When is sex safe?: Insiders' views on sexually transmitted disease prevention and treatment. Health Education & Behavior 2001;28:624-42.

Thomas JC, Weiner DH, Earp JA, Schoenbach VJ. Frequent reinfection in a community with hyperendemic gonorrhea and chlamydia: appropriate clinical actions. Int J STD AIDS 2000;11:461-7.

Thomas JC, Lansky A, Weiner DH, Earp JA, Schoenbach VJ. Behaviors facilitating sexual transmission of HIV and STDs in a rural community. AIDS and Behavior 1999;3:257-68.

Irwin DE, Thomas JC, Spitters CE, Leone PA, Stratton JD, Martin DH, Zenilman JM, Schwebke JR, Hook EW. Self-reported sexual activity and condom use among symptomatic clients attending STD clinics. Sex Trans Dis 1999;26:286-90.

Lansky A, Thomas JC, Earp JA. Partner-specific sexual behaviors among persons with both main and other partners. Fam Plan Persp 1998;30:93-6.

Irwin DE, Thomas JC, Spitters CE, Leone PA, Stratton JD, Martin DH, Zenilman JM, Schwebke JR, Hook EW. Self-treatment patterns among clients attending sexually transmitted disease (STD) clinics and the effect of self-treatment on STD symptom duration. Sex Trans Dis 1997;24:372-7.