Text messaging for sexual communication and safety among African American young adults

Peer Communication about Antisocial Activities as a Mediator of Interparental Conflict in Mid-Adolescence and Externalizing Problems in Late Adolescence

The current study investigated whether adolescent peer communication about antisocial activities mediates the association between interparental conflict within the family system in mid-adolescence and externalizing problems in late adolescence. Participants were 115 families in which an adolescent and caregiver participated in a longitudinal study. Adolescents (53 girls, 62 boys) completed measures of interparental conflict and externalizing problems in 8th grade (age 14). Afterward, adolescents received a BlackBerry device configured to capture all text messages sent and received. During the 9th grade, four days of text messages were coded for peer communication about antisocial topics. Adolescents again completed a measure of externalizing problems in 11th grade (age 17). Results indicated that interparental conflict in 8th grade correlated positively with adolescents' externalizing problems in 11th grade, but only for girls. In addition, the frequency of communication about antisocial activities mediated the link between interparental conflict and girls' externalizing problems. The findings support the idea that adolescent girls' communications about antisocial activities with their peers may contribute to the link between interparental conflict and girls' externalizing problems.

What Racism Has to Do with It: Understanding and Reducing Sexually Transmitted Diseases in Youth of Color

Sexually transmitted diseases (STDs) are high in populations of color compared to Whites. High-risk sexual behaviors are widely viewed as the key contributors to the levels of STDs, especially in adolescents and young adults. This article situates the sexual risk behaviors of Black, Indigenous, and other young people of color within the framework of racism. It begins with an overview of racial inequities in common STDs and shows how racism gives rise to several risk factors for high-risk sexual behaviors. These risk factors for STDs identified in prior research are best understood as adaptations to the challenges and constraints faced by youth in socially disadvantaged environments. Both social adversity and the mental health problems that it triggers can lead to risky sexual behaviors. Drawing on findings from prior research with youth of color, this paper describes the needed interventions that can markedly reduce STDs and their risk factors. It also describes needed research on interventions that could contribute to the knowledge and understanding of the adverse conditions fueled by racism that affect youth of color, their health, and their communities.

Sexting outside the primary relationship: Prevalence, relationship influences, physical engagement, and perceptions of “cheating”

Research has not yet investigated the frequency of sexting outside of a primary relationship. Research consistently shows that most sexting occurs within the context of a relationship, but few studies have taken relationship status into account. Additionally, limited research has investigated if sexting is considered infidelity. This study aims to fill those gaps by examining sexting outside of the primary relationship. University students and community members were asked about their sexting activities outside of their primary relationship using an online questionnaire. Results indicate that 23% of participants have sexted outside of their relationship. Those who cohabitate with their primary partner or are in a non-monogamous relationship are more likely to sext with a secondary partner. The majority of people who sext outside of their relationship do so with five or less partners and do so less than once a month, indicating that sexting outside of the primary relationship is infrequent. Seventy-five percent of those that sexted secondary partners considered this act cheating. Lastly, 36% also engaged in face-to-face sexual activity with the secondary partners they sexted. The importance of considering relationship status variables in understanding sexting and infidelity is discussed.

Mobile Phone Questionnaires for Sexual Risk Data Collection Among Young Women in Soweto, South Africa

Recall and social desirability bias undermine self-report of paper-and-pencil questionnaires. Mobile phone questionnaires may overcome these challenges. We assessed and compared sexual risk behavior reporting via in-clinic paper-and-pencil and mobile phone questionnaires. HVTN 915 was a prospective cohort study of 50 adult women in Soweto, who completed daily mobile phone, and eight interviewer-administered in-clinic questionnaires over 12 weeks to assess sexual risk. Daily mobile phone response rates were 82% (n = 3486/4500); 45% (n = 1565/3486) reported vaginal sex (median sex acts 2 (IQR: 1-3)) within 24 h and 40% (n = 618/1565) consistent condom. Vaginal sex reporting was significantly higher via mobile phone across all visits (p < 0.0001). There was no significant difference in condom use reporting by mobile phone and in-clinic paper-based questionnaires across all visits (p = 0.5134). The results show high adherence and reporting of sex on the mobile phone questionnaire. We demonstrate feasibility in collecting mobile phone sexual risk data.

Black Women's Approaches to Encourage a Male Partner to Test for HIV: Preliminary Adaptation and a Factor Analysis Study of the HIV Testing Approach Scale

BACKGROUND AND PURPOSE

Black women are disproportionately affected by HIV. Increasing status awareness through partner testing can improve status awareness and reduce transmission. Varying approaches to encourage HIV testing are described but a measurement instrument is lacking. The AIDS Discussion Strategy Scale (ADSS) was adapted into the HIV Testing Approach Scale (HTAS) to measure Black women's approaches to encourage partners to test for HIV.

METHODS

Preliminary adaptation included five steps to ensure validity. Participants comprised 158 sexually active 18-29-year-old Black women. The HTAS was analyzed with principal components analysis (PCA).

RESULTS

PCA indicated a four-factor model explaining 67% of variance. Four distinct approaches were Active Persuasion, Decisive Collaboration, Ultimatum, and Sweet Talking. The HTAS approaches demonstrated adequate reliability.

CONCLUSION

The HTAS may serve as a valid and reliable instrument for research. HIV prevention should encourage testing discussion to increase status awareness.

College students and HIV testing: cognitive, emotional self-efficacy, motivational and communication factors

Most college students have never been tested for HIV, even though they regularly have unprotected sex and multiple sex partners. Theory-based research addressing factors influencing HIV testing among college students is limited. This study explored this topic via a conceptual framework that integrates the health belief model with emotion and communication factors. Data was collected with a sample of four focus group panels, including two male and two female groups (N = 52). Transcripts for the seven discussion questions were produced based on the audio recordings of group sessions. Two research assistants reviewed, summarized and cross-validated the discussion content to address each of the four research questions under study. Students believe HIV to be a severe health threat, but feel 'invincible' about contracting the virus. Their low emotional self-efficacy is a barrier for adopting HIV testing. Gaining social approval and emotional support for making a testing decision can help them overcome the perceived fear, stigma and lack of response efficacy associated with taking the test. Students are open to receiving cues to action via confidential HIV-testing related communication from health professionals or important others as well as media messaging from various sources. Bridging the perceptual-emotional gap between perceived invulnerability and fear can help increase emotional self-efficacy in coping with HIV testing. Normalizing HIV testing as a primary care routine for harm avoidance/reduction will increase perceived benefits of testing. Communicating cues to action will help reinforce HIV testing as a societally approved and socially supported protective behavioral norm.

The Uses of Texting in Sexual Relationships Scale: Associations With Risky Sexual Behavior Among At-Risk African American Emerging Adults

Qualitative and quantitative research was used to create the Uses of Texting in Sexual Relationships scale. At-risk, predominantly African American emerging adults participated in qualitative interviews (N = 20) and quantitative surveys (N = 110) about their uses of text messaging within romantic and sexual relationships. Exploratory factor analysis of items generated from interviews resulted in four subscales: Sexting, Relationship Maintenance, Relationship Development, and Texting for Sexual Safety. Exploratory analyses indicated associations of Sexting with more instances of condomless sex, and Texting for Sexual Safety with fewer instances of condomless sex, which was moderated by relationship power. Further research on the connections between text messaging in relationships and sexual behavior among high-risk and minority young adults is warranted, and intervention efforts to decrease sexual risks need to incorporate these avenues of sexual communication.

Social Media and HIV: A Systematic Review of Uses of Social Media in HIV Communication

Background

Social media, including mobile technologies and social networking sites, are being used increasingly as part of human immunodeficiency virus (HIV) prevention and treatment efforts. As an important avenue for communication about HIV, social media use may continue to increase and become more widespread.

Objective

The objective of this paper is to present a comprehensive systematic review of the current published literature on the design, users, benefits, and limitations of using social media to communicate about HIV prevention and treatment.

Methods

This review paper used a systematic approach to survey all literature published before February 2014 using 7 electronic databases and a manual search. The inclusion criteria were (1) primary focus on communication/interaction about HIV/acquired immunodeficiency syndrome (AIDS), (2) discusses the use of social media to facilitate communication, (3) communication on the social media platform is between individuals or a group of individuals rather than the use of preset, automated responses from a platform, (4) published before February 19, 2014, and (5) all study designs.

Results

The search identified 35 original research studies. Thirty studies had low or unclear risk of at least one of the bias items in the methodological quality assessment. Among the 8 social media platform types described, short message service text messaging was most commonly used. Platforms served multiple purposes including disseminating health information, conducting health promotion, sharing experiences, providing social support, and promoting medication adherence. Social media users were diverse in geographic location and race/ethnicity; studies commonly reported users aged 18-40 years and users with lower income. Although most studies did not specify whether use was anonymous, studies reported the importance of anonymity in social media use to communicate about HIV largely due to the stigma associated with HIV. The ability to share and receive information about HIV was the most commonly reported benefit of social media use and the most common challenges were related to technology. Measures of frequency of use, satisfaction, and effects of use varied across studies.

Conclusions

Using social media to bridge communication among a diverse range of users, in various geographic and social contexts, may be leveraged through pre-existing platforms and with attention to the roles of anonymity and confidentiality in communication about HIV prevention and treatment. More robust research is needed to determine the effects of social media use on various health and social outcomes related to HIV.