College Women and Condom Use: Importance of Partner Relationship

Because women who want to use condoms as protection against STDs must gain compliance from their male partners, women's use of condoms was examined within the context of their relationships with their sexual partners. Sexual history, condom attitudes, and relationship information were gathered from a sample of 272 heterosexual college women. For the 121 women with a current sexual partner, logistic regression analyses revealed that both regular condom use and completely consistent condom use were more likely in shorter relationships and for women who perceived lower barriers to use. Regular condom use was also greater in relationships described as high in trust, whereas consistent condom use was greater for women in their first sexual relationships. In addition, many women reported using condoms early in their relationships, but changing to lower levels of use later. Implications of the current findings for safer-sex interventions are discussed.     

IS SEXUAL ORIENTATION A MATTER OF CHOICE?

Ninety women in lesbian and heterosexual couples were compared on relationship values, views of same-gender and cross-gender intimate relationships, and perceived choice of sexual orientation. Both groups reported similar values, levels of self-esteem, and capacity for intimacy. The majority in both groups described their relationships with women as more emotionally and intellectually intimate than those with men. A majority of women in lesbian couples (58%) and a third of women in heterosexual couples reported choosing the orientation of their current sexual relationship. Women with male partners did not perceive major differences between homosexual and heterosexual relationships, citing sexual attraction as the primary reason they chose a male partner. In contrast, many women with female partners characterized lesbian relationships as more intimate and equal, and less gender-role stereotyped, frequently citing these characteristics, along with sexual attraction, as reasons for their relationship preference.     

A Qualitative Exploration of Religion,Gender Norms,and Sexual Decision-Making within African American Faith-Based Communities

Human immunodeficiency virus (HIV) continues to be a prominent health and social justice issue, especially for African American communities in the Southern United States. Gender role norms, specifically within faith-based communities in the South, pose challenges to empowering women to make safer sexual health decisions. To explore perceptions of gender norms and sexual health, 42 qualitative interviews were gathered from female members of 16 predominantly African American churches in Atlanta, GA. Constructs from the theory of gender and power and the social ecological model were used to guide coding and analysis. Participants discussed their experiences with gender norms and gender-based power differentials at the institutional (i.e., church), familial, and interpersonal (i.e., intimate relationship) levels. Because of the attitudes and beliefs held by their religious communities and families, many participants recalled struggling to assert themselves in sexual relationships and recalled engaging in risky and unwanted sexual behavior, especially during their young adult years. However, as the participants matured, they worked to overturn traditional gender norms, empowering both their children and women in their religious communities to make healthy, autonomous sexual decisions. Moving forward, participants want their churches and members of their faith communities to play an active role in the empowerment of African American women and provide them with the confidence and education necessary to negotiate sexual decisions with their partners.

     

African American women's sexual satisfaction as a dimension of their sex roles

African American women's sexual satisfaction in heterosexual relationships was examined as a dimension of their sex roles. Responses to questions about sexual behaviors and interactions they preferred in primary relationships were selected from a larger study of a stratified random sample of 126 African American women. Three factors were identified: sexual responsiveness, sexual expression, and sexual interest and enthusiasm. The factors are described as profiles that may enhance or limit women's male-female sexual relationships. The implications of African American women's sexual satisfaction as an important dimension to understand in today's AIDS related sexual climate is discussed within a socio-cultural context.A modified version of this paper was presented at the American Anthropological Association, November 1987, Chicago, Illinois. The research was funded by The Center for Prevention and Control of Rape, NIMH Grant, R01 MH33603 and through a Research Scientist Career Development Award to the first author, K01 MH00269.     

Factors Influencing Condom Use Among African American Women: Implications for Risk Reduction Interventions

Examined factors associated with condom use in a community-based sample of 423 sexually active African American women. Measures were selected to reflect the components in prevailing models of health behavior. Condom users were higher on AIDS health priority, prevention attitudes, stage of change, behavioral intentions, reported more frequent and comfortable sexual communication with partners, perceived greater partner and peer approval for condom use, and reported that peers also used condoms. Women in exclusive relationships evidenced earlier stage of change, lower intentions to use condoms, fewer peers who engaged in preventive behaviors, perceived themselves to have lower risk, and had lower rates of condom use, higher education, and family income. Women in fluid relationships were at particularly high risk, with lower rates of condom use relative to women not in a relationship and greater sexual risk for HIV. Implications for HIV-risk reduction interventions with African American women are discussed.     

The 90's: gender differences in AIDS-related sexual concerns and behaviors,condom use and subjective condom experiences

To evaluate gender differences in the subjective experience and use of condoms, 193 heterosexual patrons at 13 bars in New York City were interviewed on site in 1991. Most respondents were single, middle class, and White; their ages ranged from 18 to 51 years. The data analysis was restricted to the 155 men and women who had at least 1 new partner in the 3 years preceding the survey. Respondents worried most about acquired immunodeficiency syndrome (AIDS) when engaging in sex with a new partner. 86% indicated concern about AIDS had affected their sexual behavior, most often by increasing their condom use and decreasing casual sex. 91% of women and 79% of men said that condoms give them greater peace of mind. Women worried more than men about AIDS when they had a new sexual partner and were more likely to limit their number of partners, work harder on an existing sexual relationship, give up casual sex, or give up sex with new partners. Men's subjective condom experiences were related to their penile functioning (erection and ejaculation) and the threat of loss of sexual pleasure. Multiple regression equations revealed that, among men, condom use with new partners was associated with worrying about AIDS and younger age; among women, peace of mind was a positive predictor. With casual partners, more partners led to increased condom use among women and worrying about AIDS was a predictor for men; peace of mind was predictive for both genders. 53% of men compared to 21% of women expected to meet a new sexual partner at the bar where they were interviewed, and 36% of men and 19% of women were carrying condoms with them.     

Individual,Interpersonal, and Sociostructural Factors Influencing Partner Nonmonogamy Acceptance among Young African American Women

In 2015 in the United States, the HIV diagnosis rate among African American women was 16 times that of White women, and HIV especially affected young African American women. African American women’s partnerships with nonmonogamous men may be one factor contributing to this disparity. Previous research has not adequately described factors influencing acceptance of partner nonmonogamy among African American women. To better understand this phenomenon, we interviewed 11 African American women aged 18–24 years-old who reported having sex in the past 3 months and reported knowing or suspecting a partner to have another female partner in the past 12 months. We employed a semi-structured interview guide designed to elicit in-depth, narrative responses from women about their partnerships. We used narrative analysis to interpret findings. Participants described factors that encouraged acceptance of partner nonmonogamy. These factors were social (i.e., limited partner availability, gender norms, and cultural norms), interpersonal (i.e., partner-specific comfort, sexual connection and emotional attachment, and casual partnership type), and intrapersonal (i.e., low self-esteem, loneliness, and fatalistic attitudes about nonmonogamy) in nature. The sociocultural context in which young African American women develop sexual partnerships may influence their attitudes, expectations, and behaviors within these partnerships and place them at increased risk for HIV and other sexually transmitted infections.     

Health-protective effects of attachment among African American girls in psychiatric care

African American girls in psychiatric care are at increased risk for HIV and sexually transmitted infection (STI) through sexual risk taking. Adolescent sexual behavior often reflects peer norms and behavior. Secure attachment patterns with mothers and peers might lessen the effects of negative peer influences and reduce sexual risk taking among African American girls. This study examined the relationships among mother-daughter and peer attachment, peer norms, and sexual-risk behaviors in African American girls seeking outpatient psychiatric care. A group of 12-16-year-old African American girls (N = 262; M age = 14.45 years) reported on their attachment to their mothers and peers, peer risk-taking and dating behaviors, peer pressure, and sexual-risk behaviors (e.g., number of partners, high-risk partners, and condom use). Structural equation modeling examined whether peer attachment and peer norms mediated the relationship between mother attachment and sexual risk. Findings supported peer norms, but not peer attachment, as a mediator of mother attachment and girls' sexual-risk behaviors. Findings revealed important family and peer factors for African American girls in psychiatric care. HIV prevention programs may be strengthened by improving mother-daughter relationships, addressing the importance of peer relationships, and emphasizing how secure mother-daughter relationships can temper the impact of peer norms.     

HIV/STD Risk Factors for Women with Violent Male Partners

This study compared 167 women, categorized as nonabused, emotionally abused, or physically abused in their primary relationships, on sexual risk factors. Physically abused women differed in several ways: greater STD risk, psychosocial distress, and substance use; more traditional gender role beliefs; lower self-esteem; more likely to have been raped and to engage in sex for pay; and less likely to attend the project's STD/HIV risk reduction groups. Within primary relationships, they differed in amount of decision-making power about safer sex, likelihood of nonmonogamy, use of substances before sex, and self-efficacy about initiating condom use. African American women reported higher rates of emotional abuse than White women, a finding related mainly to their lower socioeconomic status in this sample.     

Social Dominance Orientation Relates to Believing Men Should Dominate Sexually, Sexual Self-Efficacy, and Taking Free Female Condoms Among Undergraduate Women and Men

Gendered-based power affects heterosexual relationships, with beliefs in the U.S. prescribing that men dominate women sexually. We draw on social dominance theory to examine whether women??s and men??s level of support for group-based hierarchy (i.e., social dominance orientation; SDO) helps explain gender-based power beliefs and dynamics in heterosexual relationships. We conducted a laboratory study at a Northeastern U.S. university among 357 women and 126 men undergraduates who reported being heterosexual and sexually active, testing three sets of hypotheses. First, as hypothesized, women endorsed SDO and the belief that men should dominate sexually less than men did. Second, as hypothesized, among women and men, SDO was positively correlated with the belief that men should dominate sexually, and negatively correlated with sexual self-efficacy (confidence in sexual situations) and number of female condoms (a woman-controlled source of protection) taken. Third, structural equation modeling, controlling for age, family income, number of sexual partners in the past month, and perceived HIV/AIDS risk, supported the hypothesis that among women and men, the belief that men should dominate sexually mediates SDO??s association with sexual self-efficacy. The hypothesis that the belief that men should dominate sexually mediates SDO??s association with number of female condoms taken was supported for women only. The hypothesis that sexual self-efficacy mediates SDO??s association with number of female condoms taken was not supported. Results suggest SDO influences power beliefs and dynamics in heterosexual relationships. Although female condoms are an important woman-controlled source of protection, power-related beliefs may pose a challenge to their use.     

An Intersectional Analysis of Television Narratives of African American Women with African American Men on “the Down Low”

The controversial phenomenon of “the down low” has created fear and suspicion of male sexual partners among many African American women. Being on the down low refers to men that lead seemingly heterosexual lives, yet secretly have sex with other men. Popular media have portrayed this topic more widely in more recent years and generally focus on African Americans. Two popular television shows, Law and Order: Special Victims Unit and Girlfriends, have dedicated episodes centering heterosexual African American women partnered with African American men on the down low. The popular television film, Cover, features an African American woman who learns her husband secretly has affairs with other men. Black feminist thought provides an intersectional frame for analyzing the content of these portrayals of Black women in relationships with men on the down low. The analysis demonstrates that the down low associates more affluent African Americans with socially deviant behavior and issues, such as hyper-sexuality and HIV/AIDS. Further, they show newer interpretations of African American women “in love and in trouble” and that African American men often have to disguise and remain silent about their sexuality to garner acceptance into their communities.     

Condom Influence Strategies in a Community Sample of Ethnically Diverse Men and Women1

Few studies have examined comprehensively the ways in which men and women at risk for HIV infection influence their partners to use condoms. This study examines the condom influence strategies (CISs) of an ethnically diverse community sample of 113 (55% male) heterosexually active men and women. Results indicate that individuals at risk for HIV endorse a variety of CISs (withholding sex, direct request, seduction, relationship conceptualizing, risk information, deception, and pregnancy prevention) when attempting to procure condom use with a sexual partner. These CISs were related significantly and meaningfully to a set of safer sexual variables including 3 measures of condom use. Significant gender differences in CISs were not found. Results suggest that safer sexual behavior theories should continue to focus on interpersonal aspects of condom use and underscore the importance of an interpersonal approach to safer sexual intervention.     

The impact of mental health problems and religiosity on African-American girls' HIV-risk

We investigated the relationship between religiosity, mental health problems, and two sexual risk behaviors-condom use and number of partners. Participants were 80 sexually active African American girls in psychiatric care and their caregivers. Results indicated differential relationships, depending on parent versus youth report. Mother's religiosity was positively related to girls' condom use and not to girls' number of partners. Controlling for other predictors in the models, mother's religiosity explained as much as 15% of the variance in girls' condom use. Whereas parent and adolescent reports of girls' depression/anxiety and rule-breaking were positively associated with number of partners, reports of aggression were associated with having fewer partners. Neither parent nor youth reports of girls' mental health problems were associated with condom use. Controlling for other predictors in the models, girls' mental health problems accounted for as much as 31% of the variance in number of partners. Findings underscore the importance of adopting an ecological framework to understand both the risk and promotive factors for sexual risk taking among troubled girls. The roles of specific aspects of psychopathology and religiosity in relation to sexual risk behavior among African American girls in psychiatric care are discussed.     

Toward an Understanding of (Em)Power(Ment) for HIV/AIDS Prevention with Adolescent Women

Adolescent females, particularly urban and low-income youth of color, are at particular risk for HIV infection. This article uses an empowerment perspective to consider the degree to which intrapersonal and interpersonal power dynamics in heterosexual relations have an impact on condom use among high-risk youth. Participants in this study were 333 African American and European American urban youth, ages 14–19 years, who were heterosexually active. Measures focused on interpersonal and intrapersonal factors thought to be associated with condom use. This model was most useful in predicting condom use among women and least useful in predicting condom use among male participants. Implications for empowerment theory and future research are discussed.