Risky Sexual Behavior in Low-Income African American Women in the U.S.: Impact of Sexual Health Variables.

Risky Sexual Behavior in Low-Income African American Women in the U.S.: Impact of Sexual Health Variables, Beatrice E. Robinson, Karen Scheltema, and Tonya Cherry, Program in Human Sexuality 

We tested the Sexual Health Model as it applies to low-income African American women. We used logistic regression analyses to test for associations between (a) 5 operationalized constructs theorized in the Sexual Health Model to impact overall sexual health (barriers to healthy sexuality, sexual anatomy and functioning, positive sexuality, sexual health care, and cultural identity) and (b) several measures of risky sexual behavior (consistent condom use, multiple concurrent partnerships, and overall sexual risk). The sample was drawn from 306 participants in a sexual health HIV-prevention intervention targeting at-risk African American women from the metropolitan area of two large Midwestern cities, randomly assigned to an intervention or control group. A subsample of 163 African American women who reported having been sexually active with a man within the last 3 months was analyzed here. Data were collected using in-person structured interviews by trained peers. Participants received monetary reimbursement of up to $75. No significant relationship was found between acculturation and risky sexual behaviors. Having sexual difficulties was positively associated with overall sexual risk and multiple concurrent partnerships. Favorable attitudes toward condoms were positively associated with consistent condom use. Desiring or intending pregnancy was positively associated with inconsistent condom use and overall sexual risk behavior. This is the first study to demonstrate relationships between sexual difficulties, multiple concurrent partnerships, and high-risk sexual behavior overall. It confirms previous findings demonstrating a relationship between desire and intentions for pregnancy and inconsistent condom use and high-risk sexual behavior in general. It also confirms previous findings demonstrating the importance of condom attitudes in one's willingness to use condoms consistently. These findings are congruent with growing empirical support for an explicit focus on sexuality and relationships in HIV prevention. Future studies should continue to investigate these complex relationships in diverse populations and pay attention to measurement issues which make it more difficult to find consistent findings across studies.