A mixed methods examination of sexual partnerships among African American women
Davis, Teaniese Latham
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INTRODUCTION: Young people ages 15 to 24 years represent nearly half of new STDs. In 2008, African American women aged 15 to 19 had the highest rates of Chlamydia compared to any other age group or sex, representing a 9.8% increase from 2007. Individual-level behaviors among African American women alone cannot predict the disparity in HIV and STD acquisition. METHODS: This was a mixed methodology examination of the context of concurrency among African American young women. Phase 1 was a qualitative study examining the context of concurrent sexual partnerships among African American young women via semi-structured interviews with women ever concurrent. Phase II quantitatively assessed information regarding concurrent sexual partnerships. RESULTS: Reasons young women engaged in concurrent sexual partnerships were 1)sexual satisfaction, 2)relationship break, 3)forced separation, 4)transition to a new partner, 5)reacting to a partner’s concurrent sexual partnerships, 6)instrumental support, such as housing, 7)sex in exchange for money, goods, or services, and 8)as a distraction. Condom use varied in the relationships included: 1)consistent, 2)inconsistent, 3)delayed initiation, 4)discontinuation, and 5)non-condom use. Young women made decisions about condom use based on a few factors, which included: 1)perceived partner STD risk, 2)having a partner initiate condom use, 3)fear and prevention of negative outcomes, 4)uncertainty about future and status of relationship (i.e. waiting to develop trust), 5)partner status (i.e. new versus more established), and 6)general attitudes about condoms. Phase II quantitative data were analyzed using logistic regression analyses, entering dependent variables in blocks: individual-level only (block 1), individual + partner (block 2), and individual + partner + relationship (block 3). Block 3 was statistically significant based on the Hosmer-Lemeshow Goodness of Fit test (2(7)=5.82, p=.56). Young women were more likely to be concurrent who received government assistance (AOR=2.3, p=.05); had > 6 lifetime sex partners (AOR=2.8, p=.001), had a partner who made money (AOR=2.7, p=.005), and talked to other guys while having sex with the current partner (AOR=2.3, p=.03). CONCLUSIONS: HIV and STD risk reduction interventions should incorporate messages promoting economic independence to supplement messages regarding healthy sexual decision-making, as well as dual condom use with concurrent sex partners.