Pelvic Inflammatory Disease: A Narrative Review of Disparities Between Black and White Women in the United States and Strategies for Improvement.

Abstract

Pelvic Inflammatory Disease (PID) is an inflammatory syndrome of the upper female reproductive organs caused by infection, most commonly via Neisseria gonorrhoeae or Chlamydia trachomatis, spreading to one or more reproductive organs. With PID responsible for many of the major morbidities of sexually transmitted infections (STIs), such as ectopic pregnancy and chronic pelvic pain, the urgency is high to mitigate the impacts of untreated PID, especially in higher-risk populations. This paper discusses the current disparities in PID diagnosis, treatment, and management between Black and white women and proposes interventions to reduce health inequalities involving PID. To conduct this narrative review, a broad literature search was performed across the databases, PubMed and Google Scholar, using a combination of relevant keywords and headings. Current literature reports higher PID rates in Black versus white women, although disparities were shown to be attenuated after controlling for factors such as socioeconomic status and STI rate. These results may suggest that Black women are more likely to experience an asymptomatic or undiagnosed STI, supported by studies showing that Black women are less likely to report STI testing than white women. Public health efforts should focus on culturally sensitive messaging and interventions that improve sexual health awareness and behavior. Provider education interventions can also help mitigate bias and improve adherence to CDC guidelines for PID diagnosis and management, with the goal of reducing healthcare disparities and improving patient outcomes.