In Their Own Words: Romantic Relationships and the Sexual Health of Young African American Women

• Authors: Colleen Crittenden Murray, Emory University; Kendra Hatfield-Timajchy, Centers for Disease Control and Prevention; Joan Marie Kraft, Centers for Disease Control and Prevention; Anna R. Bergdall, cOak Ridge Institute for Science and Education; Melissa A. Habel, Centers for Disease Control and Prevention; Melissa Jo Kottke, Emory University; Ralph Joseph Diclemente, Emory University
• Journal Title: Public Health Reports
• Volume: Volume 128, Number Suppl 1
• Publisher: Association of Schools of Public Health | 2013, Pages 33-42
• Type of Work: Article | Post-print: After Peer Review
• Subjects: Health Sciences, Public Health; Health Sciences, General

Abstract

Objective We assessed young African American women's understanding of “dual protection” (DP) (i.e., strategies that simultaneously protect against unintended pregnancies and sexually transmitted diseases [STDs]) and how relationship factors influence their use of DP methods. Methods We conducted 10 focus groups with African American women (n=51) aged 15–24 years in Atlanta, Georgia, to identify barriers to and facilitators of their DP use. Focus group participants also completed a brief self-administered questionnaire that assessed demographics and sexual behaviors. We analyzed focus group data by theme: relationships, planning for sex, pregnancy intentions, STD worries, the trade-off between pregnancy and STDs, attitudes toward condoms and contraceptives, and understanding of DP. Results From the questionnaire, 51% of participants reported that an STD would be the “worst thing that could happen,” and 26% reported that being pregnant would be “terrible.” Focus group data suggested that most participants understood what DP was but thought it was not always feasible. Relationship factors (e.g., trust, intimacy, length of relationship, and centrality) affected pregnancy intentions, STD concerns, and use of DP. Social influences (e.g., parents) and pregnancy and STD history also affected attitudes about pregnancy, STDs, and relationships. Conclusions Although participants identified risks associated with sex, a complex web of social and relationship factors influenced the extent to which they engaged in protective behavior. The extent to which relationship factors influence DP may reflect developmental tasks of adolescence and should be considered in any program promoting sexual health among young African American women.