Self-Efficacy for Sexual Risk Reduction and Partner HIV Status as Correlates of Sexual Risk Behavior Among HIV-Positive Adolescent Girls and Women

Abstract

Little is known about the correlates of sexual risk behavior among HIV-positive adolescent girls and women in the United States. This study investigates two potential factors related to unprotected vaginal and anal intercourse (UVAI) that have yet to be thoroughly studied in this group: self-efficacy for sexual risk reduction and partner HIV status. Data was analyzed from 331 HIV-positive adolescent girls and women between 12 and 24 years old who reported vaginal and/or anal intercourse with a male partner in the past 3 months at fifteen sites across the United States. Results show that overall self-efficacy (B = -0.15, p = 0.01), self-efficacy to discuss safe sex with one's partner (B = -0.14, p = 0.01), and self-efficacy to refuse unsafe sex (B = -0.21, p = 0.01) are related to UVAI episodes. Participants with only HIV-positive partners or with both HIV-positive and HIVnegative partners showed a trend towards higher percentages of UVAI episodes compared to participants with only HIV-negative partners (F(2, 319) = 2.80, p = 0.06). These findings point to the importance of including selfefficacy and partner HIV status in risk-reduction research and interventions developed for HIV-positive adolescent girls and young women.

The Impact of Youth-Friendly Structures of Care on Retention Among HIV-Infected Youth

“…19,41,42 Developing a more robust adolescent health care workforce capable of responding effectively to important adolescent health issues such as mental health illness, sexual health, and to address complex psychosocial needs may be an important approach to increase engagement in care and strengthen self-efficacy around important healthy behaviors among YLHIV. [43][44][45] Physicians in adult primary care specialties (internal medicine and family practice) generally are not required to receive adolescent or young adult-specific training, whereas all pediatric residency programs are required to have a minimum 4-week clinical experience in adolescent medicine. 46 Providers, including pediatricians, have reported feeling inadequately prepared to discuss sensitive adolescent health issues such as mental health illness, reproductive health, and violence.…”

Abusive Experiences and Young Women's Sexual Health Outcomes: Is Condom Negotiation Self‐Efficacy a Mediator?

“…In particular, sexual self‐efficacy indicates the belief that one can engage in protective health behaviors, such as negotiating condom use, refusing unwanted sex or using condoms. Sexual self‐efficacy has been associated with adolescent and young adult women's condom and other contraceptive use . Thus, sexual self‐efficacy is a promising avenue for exploration as a mediator between abuse and unintended pregnancies and STDs.…”

Risk Factors for HIV Transmission and Barriers to HIV Disclosure: Metropolitan Atlanta Youth Perspectives

“…9 Furthermore, sexual minority AYAs engage in these risk behaviors more often than their heterosexual counterparts. 10,11 Third, unidentified HIV-infected AYAs are a significant source of secondary HIV transmission, with higher transmissibility during the acute phase of infection. [12][13][14][15] Although national data shows improvement in awareness of disease among HIV-infected individuals older than 18 years of age, black MSM report the lowest awareness percentage.…”