Mental representation of self in relationships indirectly affects young Black women’s engagement in risky sexual behaviors through psychosocial HIV/STI risk factors

• Authors: Nicole K. Gause, University of Cincinnati; Jennifer L. Brown, University of Cincinnati; Ralph Diclemente, Emory University
• Journal Title: Vulnerable Children and Youth Studies
• Volume: Volume 14, Number 1
• Publisher: Taylor & Francis | 2019-01-02, Pages 1-16
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1080/17450128.2019.1574366
• Subjects: Health Sciences, Immunology; Psychology, Behavioral; Health Sciences, Public Health
• Keywords: Black; HIV prevention; attachment; emerging adulthood; females; risky sexual behavior

Abstract

Black females are disproportionately affected by human immunodeficiency virus (HIV)/sexually transmitted infections (STIs), though individual-level sexual risk factors do not appear to explain racial/ethnic HIV incidence rate disparities. The current study examined the roles of attachment representations, working models of self and others, with psychosocial risk factors related to population-level sexual network features in association with risky sexual behaviors. A total of 560 Black emerging adult females (M age = 20.58, SD = 1.89) enrolling in a behavioral HIV prevention intervention trial completed the baseline assessment used in the current analyses. A series of multiple mediator models examined indirect effects of working models of self and others on sexual risk engagement through the following psychosocial HIV/STI risk factors: (a) partner communication self-efficacy, (b) fear of condom negotiation, (c) peer norms for risky sexual behavior, (d) partner trust and (e) sex-related alcohol expectancies. Results indicated an indirect effect of working model of self on the following: condom use with boyfriend/main partner through peer norms for risky sex (ab = .08, 95% CI [.02,.17]), any alcohol use prior to sex through peer norms for risky sex (ab = −.06, 95% CI [−.12, −.02]) and alcohol use prior to sex through sex-related alcohol expectancies (ab = −.13, 95% CI [−.21, −.05]). Findings provided evidence of a direct association between working model of self and each psychosocial HIV/STI risk factor included in the mediation models. Working model of self may help identify Black females at elevated risk for HIV/STI through these psychosocial risk factors.