What Girls Won't Do for Love: Human Immunodeficiency Virus/Sexually Transmitted Infections Risk Among Young African-American Women Driven by a Relationship Imperative

• Type of Material: Article
• Authors: Jerris L. Raiford, Centers for Disease Control and Prevention; Puja Seth, Emory University; Ralph Diclemente, Emory University
• Language: English
• Date: 2013-05-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Society for Adolescent Health and Medicine. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jadohealth.2012.09.006
• Title of Journal or Parent Work: Journal of Adolescent Health
• ISSN: 1054-139X
• Volume: 52
• Issue: 5
• Start Page: 566
• End Page: 571
• Grant/Funding Information: This study was supported by a grant from the National Institute of Mental Health (R01-MH061210) awarded to the third author.
• Keywords: SEXUAL-BEHAVIOR; Social Sciences; African-American; Pediatrics; ASSOCIATIONS; Psychology, Developmental; STIs; Relationships; Life Sciences & Biomedicine; Psychology; HIV; FEMALE ADOLESCENTS; INTERVENTIONS; ROMANTIC RELATIONSHIPS; INTIMATE PARTNER VIOLENCE; GENDER; Public, Environmental & Occupational Health; UNITED-STATES; PREVALENCE; Adolescents; Science & Technology; Sexual behavior
• Research Categories: Health Sciences, Public Health; Sociology, Ethnic and Racial Studies

Abstract

Purpose: Rates of Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) continue to increase among African-American youth. Adolescents who have a stronger identity in relation to others (relational identity) rather than to themselves (self-identity) may view intimate relationships as imperative to a positive self-concept, which may lead to risky sexual behavior and abuse. Therefore, the present study assessed the associations among a relationship imperative and HIV/STI-related risk factors and behaviors. Methods: Participants were 715 African-American adolescent females, aged 15 to 21 years. They completed measures that assessed how important a relationship was to them and HIV-related risk factors and behaviors. Participants also provided vaginal swab specimens for STI testing. Results: Multivariate logistic regression analyses, controlling for covariates, were conducted. Females who endorsed a relationship imperative (29%), compared to those who did not, were more likely to report: unprotected sex, less power in their relationships, perceived inability to refuse sex, anal sex, sex while their partner was high on alcohol/drugs, and partner abuse. Furthermore, participants with less power, recent partner abuse, and a perceived ability to refuse sex were more likely to test STI positive. Conclusion: These results indicate that if African-American adolescent females believe a relationship is imperative, they are more likely to engage in riskier sexual behaviors. Additionally, less perceived power and partner abuse increases their risk for STIs. HIV/STI prevention programs should target males and females and address healthy relationships, sense of self-worth, self-esteem and the gender power imbalance that may persist in the community along with HIV/STI risk.