These findings suggest that the neighborhood racial disparity in young adults’ acquisition of trichomoniasis is attributable to higher levels of concentrated poverty within segregated Black neighborhoods. Our findings are consistent with theory on the pathways through which racial residential segregation contributes to STI outcomes.18–20 However, previous ecological analyses found that, even after adjustment for community levels of poverty, gonorrhea rates were significantly higher in communities with greater concentrations of Black residents.15,16 Although not shown, we found similar results, but the association between neighborhood concentration of Black residents and trichomoniasis was not statistically significant once individual-level factors were introduced into the model. Consequently, the disparate findings between our study and previous research may be attributable to our use of multilevel modeling, which enables adjustment of individual-level factors that may potentially mediate or confound relationships between neighborhoods and individual outcomes