Condom use among young women: Modeling the theory of gender and power.

Abstract

Objective This study sought to articulate pathways between constructs from the Theory of Gender and Power (TGP) and their associations with sexual behavior. Design The data were collected pre-intervention during a randomized controlled HIV prevention trial. Participants were 701 sexually active, unmarried African-American females, aged 14–20, who were not pregnant, and were recruited from three health clinics in a southeastern U.S. city. Structural equation modeling was used for the analyses. Main Outcome Measure Self-reported condom use. Results Theoretical associations yielded a well-fitting structural model across initial and cross-validation samples. A significant amount of variance was explained for the variables of condom use (R2=.31, .18), partner communication (R2=.30, .26), substance use during sex (R2=.32, .51), and negative personal affect (R2=.36, .48). Partner communication (.35, .38) was the strongest predictor of condom use, negative personal affect (−.41, −.37) was the strongest predictor of partner communication, and physical risk (.54, .54) was the strongest predictor of negative personal affect. Conclusion This model provides evidence to support both direct and indirect associations between social and behavioral risk factors and condom use. Associations between TGP constructs and condom use can facilitate future development and analyses of interventions based on this theory.

Predictors of Sexual Scripts Among Young, Sexually-Active, Substance- Using African American Women

“…Concurrently, interventions targeting gender-based power imbalances that contribute to high risk sex behaviors among YSSAAW are lacking among existing HIV interventions. The Sexual Script Theory (SST) [36][37][38][39][40][41][42] and the Theory of Gender and Power (TGP) [41,[43][44][45][46][47][48] offer a theoretical framework to effectively adapt interventions to be culturally relevant to YSSAAW.…”

“…This, in turn, leads us to the TGP, which explores how gender-based power imbalances strongly influence the sexual behaviors that place AA women at high risk for HIV and constrain a woman's negotiation ability [65]. Influence and constraint are compounded by feelings of powerlessness and meekness [43]. Wingood led the focus of Connely's TGP on powerlessness of AA women in sexual decision making [44][45][46]66].…”

Gender Differences in the Influence of Protective Factors, Risk Factors, and Health Risk Behaviors on HIV Risk Behaviors Among Youth in South Florida

“…Social and cultural influences foster the development of attitudes about gender role expectations which can contribute to gender disparities in substance use, contraceptive behavior, and other health outcomes (Amaro, 1995;DePadilla et al, 2011;Gupta, 2000;Hitchcock et al, 2006;Marín, Gomez, Tschann, & Gregorich, 1997). Broering (1991) defined sexual enculturation as a process where cultural meanings of sexuality and sexual norms were passed down from generation to generation.…”

Factors Associated with African American Women’s Sexual Health and Risk Behavior: A Mixed Methods Study

“…For AAW, sexual risk is often measured by the practice of multiple sexual behaviors associated with the transmission of STIs including HIV infection (McLellan-Lemal et al, 2012). In most research studies examining AAW's sexual behavior, consistency in condom use, while varied in its definition, is typically characterized as women's use of condoms during each vaginal or anal sexual encounter occurring over a duration of 60 -90 days (Crosby et al, 2013;DePadilla, Windle, Wingood, Cooper, & DiClemente, 2011). The consistency of AAW's condom usage has often been described as low or sporadic (Perkins et al, 2014;Pfileger et al, 2013).…”

“…One study examined how specific constructs from the Theory of Gender and Power predicted condom use among a sample of 701 young AAW (DePadilla et al, 2011). Researchers tested a model generated from the Theory of Gender and Power by applying its three major social structures to examine HIV risk behaviors in a sample of AAW: sexual division of labor, structure of affective attachments and social norms, and sexual division of power (DePadilla et al, 2011).…”