<p>Assessment of sexually transmitted disease/HIV risk among young African Americans: comparison of self-perceived and epidemiological risks utilizing ecodevelopmental theory</p>

Abstract

Background Recent advances in understanding the developmental processes associated with adolescents warrant new thinking and systematic application of key concepts of risk and protective processes. This study examined the association between epidemiological and self-perceived risks of contracting sexually transmitted diseases (STDs)/HIV among young African Americans (AAs) and the multilevel factors identified using ecodevelopmental theory. Methods A retrospective cross-sectional study was conducted on wave 1 data from the National Longitudinal Study of Adolescent Health comprising 1,619 AA youth aged 14–18 years. Epidemiological and self-perceived HIV-risk indices were developed and their associations with ecodevelopmental system parameters evaluated. Results Significant discordance ( P <0.0001) in the youths’ self-perceived risk and epidemiological risk (the “gold standard”) was recorded with Cohen’s k-coefficient of 0.144 (95% CI 0.104–0.193). Adolescents who felt like talking to their mother had no trouble getting along with schoolteachers, perceived that teachers treated student fairly, experienced mother’s disapproval of their sexual debut, and had close friends who knew how to use condoms correctly, were positively related to low epidemiological risk of contracting STDs/HIV. Being older, male, and a mother’s positive attitude toward their adolescent’s use of birth control (in exosystem) were associated with high epidemiological risk of contracting STDs/HIV. Furthermore, poor connection with the mother (did not feel like talking to mother) and growing older were related to low accuracy of self-risk perception among AA youths. Conclusion The findings demonstrate the strong need to align self-perceived risk with epidemiological risk of acquiring STDs/HIV using the key multilevel ecodevelopmental system factors identified. This will require changes in relevant social attitudes and norms associated with risk measurement, and allow for a rational basis for safe health practices and behaviors among AA youths.

Utilizing a Life Course Approach to Examine HI V Risk for Black Adolescent Girls and Young Adult Women in the United States: A Systematic Review of Recent Literature

“…In total, 21 studies met the inclusion criteria (see PRISMA diagram, Figure 1). Twelve study samples 23,25,[27][28][29][30]33,37,38,[41][42][43] included adolescents aged ≤17 years, five studies 24,26,34,35,39 included emerging adults aged 18-25 years, and four studies 31,32,36,40 included both adolescent girls and emerging adult women. Eighteen studies met 100% of the checklist criteria for inclusion in the review.…”

“…44,45 most of the studies included in the review (n=14) were in metropolitan areas, and the remaining seven studies used nationally repre-sentative or regional samples. 24,31,[38][39][40][41][42] Seventeen studies used a cross-sectional study design and the remaining four studies used a longitudinal de- Life Course and HIV Risk in Black Women -Taggart et al sign. 26,27,29,32 Regarding study sample characteristics, one study focused on sexual minority adolescent girls, 33 one study focused on shelter-living homeless youth, 34 and three studies included parent-adolescent dyads.…”

“…Of the 16 studies, three studies 25,28,37 assessed adolescent HIV and sexual health knowledge, four studies 31,32,36,37 used self-report or laboratory confirmed STI history, and three studies 27,31,40 included measures of substance use as determinants of adolescent girls' HIV-related behaviors. One study used data from adolescent and emerging adult African American women (N=1862) who participated in one of three randomized controlled trials (RCTs) conducted in Atlanta, Georgia.…”

“…A number of studies also examined family structure and parental influence as determinants of HIV-related behaviors. Three studies 25,37,43 assessed parental communication, one study 27 assessed parental communication with maternal rejection, two studies 25,43 measured parental monitoring, and four studies 25,28,31,37 included parental attitudes and knowledge about HIV and sexual health. For example, Shah et al measured PrEP acceptability and barriers in a sample of 102 African American adolescent (66.7% female) and parent pairs seeking health care at an adolescent clinic and emergency department.…”

“…24,26,31,32,[34][35][36]39,40 Most of these studies assessed individual-level factors related to psychosocial risk, identity, cognitive functioning, and other risk behaviors as determinants of HIV-related behaviors. Three studies 26,31,40 assessed substance use and found that drug and alcohol use was positively associated with sexual risk behaviors. For example, one study created a syndemic index of psychosocial risk factors (ie, depression, drug use, alcohol use, and anxiety) to examine the relationship between psychosocial risk trajectories during adolescence and HIV-related behaviors in adulthood.…”