HIV-Related Sexual Risk Behavior Among African American Adolescent Girls

Abstract

Background: Latent class analysis (LCA) is a useful statistical tool that can be used to enhance understanding of how various patterns of combined sexual behavior risk factors may confer differential levels of HIV infection risk and to identify subtypes among African American adolescent girls. Methods: Data for this analysis is derived from baseline assessments completed prior to randomization in an HIV prevention trial. Participants were African American girls (n = 701) aged 14-20 years presenting to sexual health clinics. Girls completed an audio computer-assisted self-interview, which assessed a range of variables regarding sexual history and current and past sexual behavior. Results: Two latent classes were identified with the probability statistics for the two groups in this model being 0.89 and 0.88, respectively. In the final multivariate model, class 1 (the ''higher risk'' group; n = 331) was distinguished by a higher likelihood of > 5 lifetime sexual partners, having sex while high on alcohol/drugs, less frequent condom use, and history of sexually transmitted diseases (STDs), when compared with class 2 (the ''lower risk'' group; n = 370). The derived model correctly classified 85.3% of participants into the two groups and accounted for 71% of the variance in the latent HIV-related sexual behavior risk variable. The higher risk class also had worse scores on all hypothesized correlates (e.g., self-esteem, history of sexual assault or physical abuse) relative to the lower risk class. Conclusions: Sexual health clinics represent a unique point of access for HIV-related sexual risk behavior intervention delivery by capitalizing on contact with adolescent girls when they present for services. Four empirically supported risk factors differentiated higher versus lower HIV risk. Replication of these findings is warranted and may offer an empirical basis for parsimonious screening recommendations for girls presenting for sexual healthcare services.

The role of feature-based discrimination in driving health disparities among Black Americans

“…High self-esteem contributes to psychological resilience, allowing individuals to cope with and quickly recover from stress (Chan, Lai, and Wong 2006;Harris et al 2016;Yi et al 2008). High self-esteem can also prevent individuals from engaging in risky health behaviors, such as binge-drinking and unprotected sex (Danielson et al 2014;Gullette and Lyons 2006).…”

Differences in the ability to predict and prepare for sexual activity between HIV-infected and HIV-uninfected young South African Women

“…Current research highlights behaviors that put individuals at high risk of contracting HIV, but there is a paucity of studies that investigate and compare sexual behavior patterns between HIV-infected and HIV-uninfected young women. Increased risk of HIV transmission in young women has been found to be associated with greater than five lifetime sexual partners, having sex while under the influence of alcohol/drugs, less frequent condom use, prior pregnancy, and history of sexually transmitted infections (STIs) ( Danielson et al, 2014 ). In addition, poor self-esteem and history of sexual or physical abuse has also been associated with higher risk of infection ( Danielson et al, 2014 ).…”

“…Increased risk of HIV transmission in young women has been found to be associated with greater than five lifetime sexual partners, having sex while under the influence of alcohol/drugs, less frequent condom use, prior pregnancy, and history of sexually transmitted infections (STIs) ( Danielson et al, 2014 ). In addition, poor self-esteem and history of sexual or physical abuse has also been associated with higher risk of infection ( Danielson et al, 2014 ). Young women may mistakenly perceive their risk of HIV transmission to be low given current monogamy, trust in current partner, and lack of injection drug use ( Danielson et al, 2014 ; Overby and Kegeles, 1994 ).…”

“…In addition, poor self-esteem and history of sexual or physical abuse has also been associated with higher risk of infection ( Danielson et al, 2014 ). Young women may mistakenly perceive their risk of HIV transmission to be low given current monogamy, trust in current partner, and lack of injection drug use ( Danielson et al, 2014 ; Overby and Kegeles, 1994 ). At risk young women have been found to be more concerned about issues relating to poverty, than HIV risk ( Overby and Kegeles, 1994 ).…”

Understanding Psychosocial and High-Risk Sexual Behaviors Among Detained Juveniles: A Descriptive Study Protocol

“…Vulnerable young African American women without a history of incarceration share similar characteristics with young African American women with a juvenile detention history, such as limited educational achievement, low socioeconomic status, limited utilization of health care services, unprotected sex, and substance use [ 18 , 19 ]. Studies of vulnerable young African American women suggest that these individuals exhibit high-risk sexual behaviors compared to nonvulnerable peers, have more lifetime sexual partners, engage in sex while high on drugs and alcohol, have low condom self-efficacy, do not use condoms consistently, and are more likely to have STIs [ 15 , 18 , 20 ].…”