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.

     

Preliminary efficacy of a computer-based HIV intervention for African-American women

This study evaluated the preliminary efficacy of a computer-based HIV intervention to enhance HIV-protective sexual behaviours, based on a randomised controlled trial among 135 African-American women, 21-29 years of age, seeking services at Planned Parenthood in Atlanta, GA. Participants were randomised either to a control session two, 60-minute computer-based HIV intervention sessions administered on a laptop computer that each concluded with a 15-minute small group session or to a control session of general health information including discussion on HIV prevention. Relative to controls, participants in the computer-based HIV intervention were more knowledgeable about HIV/STD prevention and reported higher scores on the measure of condom use self-efficacy at 3 months post-intervention; they also reported a higher percentage of condom-protected sex and were more likely to use condoms consistently for vaginal sex (odds ratio, OR = 5.9; p < 0.039) and were more likely to use condoms consistently for oral sex (OR = 13.83; p < 0.037). This relatively brief intervention provides preliminary support that an evidence-based group-based HIV prevention intervention for young African-American women can be adapted to a computer-based HIV intervention.     

AIDS knowledge among black drug users: an issue of reliability

This study examined the reliability of an inventory measuring AIDS-related knowledge among 553 black drug users. Data were collected from a socially high-risk community in Birmingham, Alabama. The KR-20 reliability scores were computed from the inventory for each drug-use group. The KR-20 reliabilities ranged from .39 to .57. These findings may suggest that the inconsistent reports of the predictive power of AIDS knowledge among drug users reported in previous studies might be related to the low internal consistencies of the inventory.     

Partner Influences and Gender-Related Factors Associated with Noncondom Use Among Young Adult African American Women

We examined the partner influences and gender-related correlates of noncondom use among African American women. The prevalence of noncondom use was 45.3%. Women whose sexual partners were noncondom users were four times more likely to believe that asking their partner to use a condom implied he was unfaithful, three times as likely to have a partner who resisted using condoms, three times more likely to receive AFDC, twice as likely to be sexually nonassertive, three times more likely to believe that it was not difficult to find an eligible African American man, and three times as likely to have had one sexual partner. HIV prevention tailored towards African American women should address these partner influences and gender-related factors.     

Feelings Matter: Depression Severity and Emotion Regulation in HIV/STI Risk-Related Sexual Behaviors

Human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention models may not address psychological complexities among adolescents with mental illnesses. This study examined contextual factors related to HIV/STI risk among heterosexually active Black adolescents with mental illnesses to inform the development of targeted HIV/STI prevention strategies. Black adolescent males and females (aged 14–17) were recruited from outpatient mental health programs in Philadelphia, PA to complete a computer-assisted personalized interview on sociodemographics, sexual behaviors, and emotion regulation (N?=?53). Two sample t-tests, Wilcoxon Rank Sum tests and regression modeling were used to examine differences in the study measures by gender and relationship status. Reports of sexual partner concurrency were high—both while already in a sexual relationship (67.3%) and multiple sexual partners in the same day (42.3%). Boys reported significantly more risk behaviors than girls. Sadness dysregulation predicted currently being in a relationship, older age at first oral sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters. Coping difficulties predicted a greater number of vaginal and oral sexual partners, and a lower age at first vaginal sex. Increasing depression severity was related to older age at first vaginal sex, fewer vaginal sexual partners and fewer unprotected oral sexual encounters in the past 3 months. This formative work suggests that coping mechanisms should be addressed in HIV/STI prevention research through the inclusion of activities targeted toward emotion regulation and decreasing sexual risk behaviors. Psycho-education and skills building may mitigate the psychopathology that contributes to HIV/STI risk in the target demographic.     

Impact of Abuse History on Adolescent African American Women's Current HIV/STD-Associated Behaviors and Psychosocial Mediators of HIV/STD Risk

This study examined if relationship power, sex refusal self-efficacy, or fear of condom negotiation mediated the relationship between abuse history and consistent condom use (CCU) among African American female adolescents (N?=?593). Participants with an abuse history (58%) were less likely to report CCU. Women with an abuse history reported less relationship power and self-efficacy for refusing sex and more fear of condom negotiation, none of which independently or jointly mediated the association between abuse and CCU. Notably, history of abuse was associated with CCU across mediator models despite inclusion of psychosocial mediators. This study demonstrates the importance of understanding adolescents' condom use behaviors within the context of their life experiences, especially past abuse history.     

The impact of depressive symptomatology on risky sexual behavior and sexual communication among African American female adolescents

Adolescents, particularly African American adolescents, are at high risk for sexually transmitted infections (STIs). The association between psychosocial factors and risky sexual behavior has been well established. However, only a small number of studies have examined the relationship between depressive symptomatology among African American female adolescents, specifically over time. The present study examined depressive symptoms as a predictor of risky sexual behavior, sexual communication, and STIs longitudinally among African American female adolescents between the ages 15 and 21. Binary generalized estimating equation models were conducted assessing the impact of depressive symptoms at baseline on risky sexual behavior and STIs over six- and 12-months follow-up. Age, intervention group, and baseline outcome measures were entered as covariates. The results indicated that high levels of depressive symptoms predicted no condom use during last sexual encounter and multiple sexual partners over six-months follow-up. Depressive symptoms also predicted having a main partner with concurrent partners, high fear of communication about condoms, and sex while high on alcohol or drugs over six- and 12-months follow-up. These findings could be used to inform HIV/STI prevention intervention programs and clinicians providing regular health care maintenance to African American female adolescents engaging in risky sexual behavior.