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Osakwe CE, van der Drift I, Opper CA, Zule WA, Browne FA, Wechsberg WM. Condom Use at Last Sex and Sexual Negotiation Among Young African American Women in North Carolina: Context or Personal Agency. J Racial Ethn Health Disparities 2024; 11:2256-2264. [PMID: 37495904 PMCID: PMC10811276 DOI: 10.1007/s40615-023-01693-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 07/28/2023]
Abstract
African American women are 10.8 times more likely to be diagnosed with HIV compared with White women. This descriptive study fills a gap by examining associations among social and contextual factors and sexual communication, condom use, and safer sex negotiation among African American women. Study participants between 18 and 25 years of age and who reported recent substance use were recruited from three North Carolina counties. A risk behavior survey was administered via audio computer-assisted self-interview, and logistic regression analyses were conducted to assess associations between social and contextual variables and condom use at last sex with a main partner. Education (AOR: 2.078; 95% CI: 1.214, 3.556), sexual communication with a main partner (AOR: 1.079; 95% CI: 1.050, 1.109), and condom use relationship scale (AOR: 1.059; 95% CI: 1.023, 1.098) were positively associated with condom use at last sex, whereas living with a main partner (AOR: 0.447; 95% CI: 0.210, 0.950) and the alcohol and drug problem scale (AOR: 0.971; 95% CI: 0.944, 0.998) were negatively associated with condom use (p < 0.05). The study findings show that among young African American women at risk for HIV, contextual and personal factors may influence condom use. A socio-ecological approach combining personal empowerment, interpersonal, structural, and biobehavioral strategies is necessary in implementing holistic gender-focused HIV prevention programs.
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Affiliation(s)
| | - Isa van der Drift
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 East Cornwallis Road, PO Box 12194, NC, 27709-2194, Durham, USA
| | - Claudia A Opper
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 East Cornwallis Road, PO Box 12194, NC, 27709-2194, Durham, USA
| | - William A Zule
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 East Cornwallis Road, PO Box 12194, NC, 27709-2194, Durham, USA
| | - Felicia A Browne
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 East Cornwallis Road, PO Box 12194, NC, 27709-2194, Durham, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Wendee M Wechsberg
- Substance Use, Gender, and Applied Research Program, RTI International, 3040 East Cornwallis Road, PO Box 12194, NC, 27709-2194, Durham, USA.
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
- Department of Psychology, North Carolina State University, Raleigh, NC, USA.
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
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Logan-Greene P, Bascug EW, DiClemente RJ, Voisin DR. Heterogeneity of Sexual Risk Profiles Among Juvenile Justice-Involved African American Girls. CHILD & YOUTH CARE FORUM 2021. [DOI: 10.1007/s10566-020-09594-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Banks DE, Hensel DJ, Zapolski TCB. Integrating Individual and Contextual Factors to Explain Disparities in HIV/STI Among Heterosexual African American Youth: A Contemporary Literature Review and Social Ecological Model. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1939-1964. [PMID: 32157486 PMCID: PMC7321914 DOI: 10.1007/s10508-019-01609-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/03/2019] [Accepted: 12/10/2019] [Indexed: 05/21/2023]
Abstract
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.
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Affiliation(s)
- Devin E Banks
- Department of Psychology, Indiana University Purdue University-Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA.
| | - Devon J Hensel
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tamika C B Zapolski
- Department of Psychology, Indiana University Purdue University-Indianapolis, 402 N. Blackford St., LD 124, Indianapolis, IN, 46202, USA
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