Pathways from Racial Discrimination to Multiple Sexual Partners Among Male African American Adolescents

The Strong African American Families Program: Disrupting the Negative Consequences of Racial Discrimination Through Culturally Tailored, Family-Based Prevention

Racism continues to be a major source of stress for African Americans and can impair psychological functioning. Adolescents experiencing discrimination may engage in self-soothing, but risky behaviors, which leave them at risk for negative life trajectories. Black pride has been identified as a key factor in explaining the heterogeneity in responses to discrimination. Racial socialization, strategies parents use to promote Black pride and protect youth from discrimination, is an important focus of family-based prevention programs serving African American families. This study tests the efficacy of a culturally tailored preventive intervention for rural African American families to disrupt the negative consequences of discrimination on adolescent psychological functioning. Four waves of data from the Strong African American Families (SAAF) efficacy trial (Murry & Brody in Journal of Marital & Family Therapy 30(3):271-283, 2004) with 667 African American families in rural Georgia were used for this study. Structural equation modeling was used to test study hypotheses. Adolescent experiences with discrimination at age 15 predicted concurrent psychological functioning and multiple risk behaviors at age 16, including sexual risk behavior, substance use problems, academic failure, and juvenile justice involvement. Mediation analyses demonstrated that psychological functioning was a significant mediator of these relations. The SAAF program was associated with increases in racial socialization, which in turn fostered gains in adolescent Black pride. Black pride was indirectly associated with reduced risk behavior through adolescent psychological functioning, but Black pride did not moderate the effect of discrimination on psychological functioning. This study confirms that family-based prevention can support African American adolescent mental health in the context of discrimination. However, more emphasis on reducing exposure to discrimination is needed.

Shift-and-persist coping and health among rural African American adolescents

This study examines whether shift-and-persist coping, a coping strategy defined by accepting challenges and remaining hopeful for the future, is associated with psychosocial and physical health and/or moderates the effects of contextual stress (i.e., racial discrimination, financial strain) on health among African American adolescents living in the rural Southeastern United States. Participants (N = 299, 56% boys, Mage  = 12.91) completed measures of shift-and-persist coping, contextual stress, and psychosocial and physical health. Shift-and-persist coping was generally associated with better health but did not buffer the effects of contextual stress. Results suggest that shift-and-persist coping may serve as a source of resilience among African American adolescents living in a context where many experience heightened contextual stress.

Racial socialization and discrimination-related psychological distress in middle-aged Black men and women

Our objectives were to evaluate gender-specific associations of racial discrimination with psychological sequelae among middle-aged Blacks and to evaluate the capacity of racial socialization to moderate the association between discrimination and psychological distress, accounting for relevant prospectively assessed childhood factors. We used data from the Child Health and Development Disparities Study that followed a Northern California-based group of Blacks from the prenatal period through midlife (N = 244, 49.6% female). Multiple regression analyses were performed separately by gender to assess (a) the main effects of racial socialization and racial discrimination on adult psychological distress, (b) racial socialization as a moderator of the association between racial discrimination and adult psychological distress, and (c) whether controls for prospectively assessed childhood factors changed conclusions regarding the role of racial socialization. Seventy percent of the middle-aged Blacks in our sample reported having at least one type of major experience of racial discrimination. Increased reports of racial discrimination were positively associated with psychological distress in men, but not in women. Similarly, racial socialization was associated with decreased overall distress for men, but not for women. Discrimination-related distress was attenuated for men who reported higher levels of racial socialization. These findings remained after adjustment for childhood socioeconomic status (SES), childhood internalizing symptoms, parental marital separation, and number of siblings. Findings suggest that racial socialization conferred a protective psychological effect through midlife to Black men who experienced racial discrimination, a commonplace experience in this cohort. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Dyadic Analysis Exploring the Mediating Role of Relationship Quality on Discrimination and HIV/STI Risk Among Young Black and Latino Expecting Couples

Encounters with discrimination are a normative experience for many Black and Latino adolescents and young adults (AYAs); these experiences may be even more common for expecting AYAs. While the harmful effects of discriminatory experiences on mental and physical health have been well explored, relatively little is known regarding the impact of discrimination on relationship quality and sexual health-specifically HIV/STI risk.Using the Actor Partner Interdependence Model, we examined both actor and partner effects of discrimination on relationship quality and willingness to be non-monogamous in a sample of 259 pregnant adolescent and young adult couples. There was a significant indirect actor effect, such that one's own discrimination was associated with a decrease in their own relationship quality which, in turn, was associated with their own greater willingness to be non-monogamous. The partner effect for the association of one's partner's discrimination on one's own relationship quality was not significant. Findings highlight the need for more attention to the implications of discrimination on relational and sexual health.

Racial Discrimination, Protective Parenting, and Binge Drinking Among Emerging Adult Black Men

PURPOSE

Rural Black men experience escalating rates of binge drinking during emerging adulthood. We hypothesized that exposure to racial discrimination would predict growth in their binge-drinking trajectories and that protective parenting, including emotional and instrumental support and high expectations for success, would attenuate the influence of racial discrimination on growth in binge drinking.

METHODS

Hypotheses were tested with 3 waves of data from 505 men (ages 20.3, 21.9, and 23.1) participating in the African American Men's Project. Conditional and multigroup latent growth curve models (LGCMs) were implemented using Mplus.

RESULTS

LGCM indicated that binge-drinking frequency increased linearly across time; exposure to racial discrimination at baseline predicted growth in binge drinking (β = 0.19, p < 0.01). Multigroup comparison procedures indicated significant moderation by protective parenting. When protective parenting was high, racial discrimination had no significant influence on rates of young men's binge drinking (β = 0.01, p = 0.51). In contrast, when protective parenting was low, the influence of discrimination was heightened (β = 0.21, p < 0.01).

CONCLUSIONS

Racial discrimination is a pernicious stressor that contributes to increases in binge drinking among young Black men. When parents engaged in emotionally and instrumentally supportive parenting, however, racial discrimination had little influence on binge-drinking trajectories during emerging adulthood. Study findings underscore the importance of the emerging adult transition as a period of vulnerability and suggest directions for targeting alcohol preventive interventions.

IMPLICATIONS AND CONTRIBUTION

After high school, young Black men are exposed to racial discrimination that can increase rates of binge drinking. When young men's parents were emotionally and instrumentally supportive toward them, however, racial discrimination did not predict increases in binge drinking.

Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model

Heterosexual African American youth face substantial disparities in sexual health consequences such as HIV and STI. Based on the social ecological framework, the current paper provides a comprehensive, narrative review of the past 14 years of literature examining HIV/STI risk, including risky sexual behavior, among heterosexual African American youth and a conceptual model of risk among this population. The review found that individual psychological and biological factors are insufficient to explain the sexual health disparities faced by this group; instead, structural disadvantage, interpersonal risk, and community dysfunction contribute to the disparity in HIV/STI outcomes directly and indirectly through individual psychological factors. The conceptual model presented suggests that for African American youth, (1) HIV/STI risk commonly begins at the structural level and trickles down to the community, social, and individual levels, (2) risk works in a positive feedback system such that downstream effects compound the influence of structural risks, and (3) contextual and individual risk factors must be considered within the advanced stage of the epidemic facing this population. Despite advanced HIV and STI epidemics among heterosexual African American youth, multisystemic interventions that target structural risk factors and their downstream effects are posited to reduce the disparity among this high-risk population.

Direct and indirect effects of a couple-focused preventive intervention on children's outcomes: A randomized controlled trial with African American families

OBJECTIVE

This study examined the effects of the Protecting Strong African American Families (ProSAAF) prevention program on children's outcomes more than 2 years after enrollment, including direct effects of the intervention and indirect effects through couple functioning and parent-child relations.

METHOD

Three hundred forty-six African American couples with an early adolescent child participated; all families lived in rural, low-income communities in the southern United States. Families were randomly assigned to ProSAAF or control conditions and completed four waves of data collection. Couples reported couple functioning at baseline (Wave 1) and at 9-month follow-up (Wave 2), and parent-child relations at 17-month follow-up (Wave 3). Children reported their conduct problems, affiliation with deviant peers, substance use, sexual onset, depressive symptoms, and self-control at 25-month follow-up (Wave 4).

RESULTS

Path analyses indicated significant indirect effects of ProSAAF on children's outcomes through improvements in couple functioning and better parent-child relations. There were no significant direct effects of the intervention on children's outcomes or significant indirect effects through couple functioning alone.

CONCLUSIONS

This couple-focused prevention program has positive indirect effects on several child outcomes through the intervening processes of promoting improvements in couple functioning and better parent-child relations. These findings provide cautious optimism regarding the possible benefits of couple-focused programming on participants' children while suggesting ways in which future couple-focused interventions could yield stronger effects on these youth. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Understanding African American youth and adult perspectives on sex education in rural North Carolina

African American youth in the US rural South are at elevated risk for poor sexual health outcomes, including sexually transmitted infections and teen pregnancy. Historically, the southeastern USA has lagged behind in providing comprehensive sexuality-based education in secondary school, which may contribute to poor reproductive and sexual health outcomes. This study aims to understand the perspectives of African American youth and adults on comprehensive sexuality-based education in rural North Carolina. Twenty-four individuals (12 youth and 12 adults) participated in both semi-structured interviews and small discussion groups. Data were analysed and coded using inductive and deductive approaches to thematic analysis. Results indicated that comprehensive sexuality-based education was highly desirable; however, current efforts were viewed as insufficient. While both young people and adults agreed that abstinence was the most desirable path for youth, participants also acknowledged young people's autonomy in engaging in sexual activity and suggested that comprehensive sexuality-based education was needed to protect against unintended consequences. The findings of this study have practical implications for addressing challenges associated with providing sexuality-based education to African American youth in rural communities and offers suggestions regarding directions for future research.

Gendered Social Institutions and Preventive Healthcare Seeking for Black Men Who Have Sex with Men: The Promise of Biomedical HIV Prevention

Research on gender and health, including research conducted among Black men who have sex with men (BMSM), has primarily focused on how gender norms and roles shape healthcare engagement. Here we advance that work by demonstrating how a broader theorization of gender, particularly one that moves beyond gender norms and performance to incorporate structures such as the healthcare system and the labor market, can facilitate an understanding of how gender affects preventive healthcare seeking among BMSM, particularly the uptake of pre-exposure prophylaxis (PrEP), a promising approach to alleviate HIV disparities. This article is based on a year-long ethnographic study conducted in New York City with BMSM (n = 31; three interviews each) and community stakeholders (n = 17). Two primary findings emerged: (1) the labor market systematically excluded the men in our sample, which limited their ability to access employer-sponsored healthcare. Such discrimination may promote overt demonstrations of masculinity that increase their HIV vulnerability and decrease healthcare seeking, and (2) healthcare systems are not structured to promote preventive healthcare for men, particularly BMSM. In fact, they constrained men's access to primary providers and were usually tailored to women. Applying a structural, gendered lens to men's health-in addition to the more frequently researched individual or interpersonal levels-provides insight into factors that affect healthcare seeking and HIV prevention for BMSM. These findings have implications for the design of policies and institutional reforms that could enhance the impact of PrEP among BMSM. Findings are also relevant to the management of chronic disease among men more broadly.

Racial/ethnic discrimination and well-being during adolescence: A meta-analytic review

This meta-analytic study systematically investigates the relations between perceived racial/ethnic discrimination and socioemotional distress, academics, and risky health behaviors during adolescence, and potential variation in these relations. The study included 214 peer-reviewed articles, theses, and dissertations, with 489 unique effect sizes on 91,338 unique adolescents. Random-effects meta-analyses across 11 separate indicators of well-being identified significant detrimental effects. Greater perceptions of racial/ethnic discrimination were linked to more depressive and internalizing symptoms; greater psychological distress; poorer self-esteem; lower academic achievement and engagement; less academic motivation; greater engagement in externalizing behaviors, risky sexual behaviors, and substance use; and more associations with deviant peers. Metaregression and subgroup analyses indicated differences by race/ethnicity, Gender × Race/Ethnicity interactions, developmental stage, timing of retrospective measurement of discrimination, and country. Overall, this study highlights the pernicious effects of racial/ethnic discrimination for adolescents across developmental domains and suggests who is potentially at greater risk. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Pathways to HIV-Related Behavior Among Heterosexual, Rural Black Men: A Person-Centered Analysis

We investigated the psychosocial mechanisms linking personal and contextual risk factors to HIV-related behavior among 498 rural Black men. We characterized HIV-related behavior in terms of profile groups and hypothesized that contextual and personal risk factors (childhood adversity, community disadvantage, incarceration, and racial discrimination) would predict HIV-related behavior indirectly via two psychosocial mechanisms: impulsivity and negative relational schemas. Study results documented three HIV-related behavior profile groups. The Safer group reported low levels of risky behavior. The Risk-Taking group reported inconsistent condom use and elevated substance use. The Multiple Partners group reported the highest numbers of partners and relatively consistent condom use. Risk factors predicted profile groups directly and indirectly through psychosocial mechanisms. Impulsivity mediated the association between community disadvantage and membership in the risk-taking group. Negative relational schemas mediated the associations of childhood experiences and community disadvantage with membership in the multiple partners group. Specificity in pathways suggests the need for targeted interventions based on multidimensional characterizations of risk behavior.

Father Involvement and Young, Rural African American Men's Engagement in Substance Misuse and Multiple Sexual Partnerships

This study was designed to examine the associations of biological father and social father involvement during childhood with African American young men's development and engagement in risk behaviors. With a sample of 505 young men living in the rural South of the United States, a dual mediation model was tested in which retrospective reports of involvement from biological fathers and social fathers were linked to young men's substance misuse and multiple sexual partnerships through men's relational schemas and future expectations. Results from structural equation modeling indicated that levels of involvement from biological fathers and social fathers predicted young men's relational schemas; only biological fathers' involvement predicted future expectations. In turn, future expectations predicted levels of substance misuse, and negative relational schemas predicted multiple sexual partnerships. Biological fathers' involvement evinced significant indirect associations with young men's substance misuse and multiple sexual partnerships through both schemas and expectations; social fathers' involvement exhibited an indirect association with multiple sexual partnerships through relational schemas. Findings highlight the unique influences of biological fathers and social fathers on multiple domains of African American young men's psychosocial development that subsequently render young men more or less likely to engage in risk behaviors.

Racial microstressors, racial self-concept, and depressive symptoms among male African Americans during the transition to adulthood

Racial discrimination is a pervasive stressor that can undermine mental health among African American youth and young adults. Several studies identify links between racial discrimination and depressive symptoms; however, this research base does not focus on male African American youth who experience significant racism-related stress during the transition to young adulthood. Moreover, few prospective studies consider significant confounding variables that affect exposure to and perception of discriminatory treatment. In response to this need, we examined the effect of exposure to racial discrimination from ages 16 to 18 on depressive symptoms among male African Americans at age 20. Racial self-concept, one's sense of positivity about one's race, was examined as a mediator and self-control as a moderator. Hypotheses were tested with 222 participants, age 16 at baseline and age 20 at the endpoint. Participants provided self-report data at five time points. Exposure to racial discrimination from ages 16 to 18 predicted depressive symptoms at age 20, net of confounding influences. Racial self-concept mediated this effect. Self-control moderated the influence of discrimination on racial self-concept. This study underscores the salience of racial discrimination in the development of depressive symptoms among African American male youth and the clinical utility of interventions targeting racial pride and self-control.