Date of Award

Spring 4-9-2026

Document Type

Honors Thesis

Department/Major

Health Science

First Advisor

Wynette Mockler

Second Advisor

Kacee Redden-Benz

Third Advisor

N/A

Keywords

Sexually transmitted infections (STI), poverty, sexual health education, South Dakota

Subject Categories

Community Health and Preventive Medicine | Epidemiology | Public Health Education and Promotion | Women's Health

Abstract

Rural and frontier communities in the Upper Midwest face unique challenges that shape how young people access sexual health information and testing. While sexually transmitted infection (STI) rates continue to rise nationally, less is known about how sexual health education, digital access, and geographic distance influence these trends at a county level. This study examines the relationship between broadband internet access rates, poverty rates, proximity to free or low-cost STI testing sites, and county-level STI rates among individuals aged 15-24 in selected counties across South Dakota, North Dakota, Minnesota, Iowa, and Nebraska. Using an ecological, cross-sectional design, county-level STI surveillance data from the Centers for Disease Control and Prevention and Census, estimates of broadband access and poverty were analyzed.

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