Social and Environmental Influences on Sexual Behaviors of College Black Women: Within Group Diversity Between HBCU vs. PWI Experiences

Abstract

Black women carry a disproportionate number of new HIV infections in the USA. Studies that have assessed HIV risk perception along with HIV prevention interventions for Black women have primarily focused on Black women of low socioeconomic status. Few studies have assessed HIV risk perceptions and sexual behavior among college-educated Black women of higher socioeconomic status despite their high risk of HIV. College-educated Black women are most likely to acquire HIV while in college, and there has been a marked absence of research assessing the environmental and cultural influences present throughout collegecampuses, coupled with evaluating how these factors shape sexual behaviors. We conducted surveys with Black female students attending a historically Black college and Black female students attending a predominately White university, and compared baseline differences in sexual behaviors among both populations. Results showed that for participants attending the historically Black college certain sociocultural elements, such as music and media, had a significantly stronger influence on sexuality and sexual behaviors compared with students attending predominately White universities. The development of future HIV prevention interventions for Black women necessitates an understanding of the diverse microcultures that Black women come from. This research is high priority for college-educated Black women given this population's lack of inclusion in HIV prevention research.

Just in case: undergraduate students identifying and mitigating barriers to their sexual and reproductive health needs

“…While college-aged youth’s access to sexual health resources and promotion can increase contraceptive use [ 14 , 32 ] and decrease unsafe sex behaviors and practices [ 21 , 43 ], sexual and reproductive healthcare disparities persist among groups of U.S. undergraduate students, especially those students attending institutions of higher education with limited access to student-based clinics and resources [ 1 , 9 , 25 ]. Furthermore, the burden of sexual health disparities in U.S. youth varies across identities [ 1 , 4 , 12 , 27 , 44 , 45 ] and social determinants of health [ 1 , 11 , 27 , 46 ], suggesting that access to SRH services, knowledge, and resources for U.S. students is a matter of increased urgency. This article highlighted preliminary findings of the effectiveness of a student-led, sexual, and reproductive health wellness delivery strategy among U.S. undergraduate students with limited access to SRH resources, services, and knowledge.…”

“…Sexual health disparities—such as sexually transmitted infections (STIs) [ 1 ], unintended pregnancies [ 2 ], and relationship-based [ 3 , 4 ] and sexual violence [ 5 , 6 ]—significantly impact U.S. post-secondary students’ educational trajectories and outcomes [ 7 , 8 ]. For instance, risky sexual health practices [ 9 ], inconsistent or incorrect use of contraceptives [ 10 ], lack of access to sexual and reproductive health (SRH) preventive services [ 11 , 12 ], resources and information [ 13 ], and gaps in sexual health knowledge due to differential access to comprehensive and scientifically-based sexual health education in K-12 contexts [ 14 , 15 ], among others, have been connected to unplanned pregnancies, which can impact timely degree completion [ 16 – 18 ].…”

Applying a Nursing Perspective to Address the Challenges Experienced by Cisgender Women in the HIV Status Neutral Care Continuum: A Review of the Literature

“…Current clinical and research efforts tend to focus highly on low-income Black women who may not have high educational attainment and who may not have access to resources (Chandler, Guillaume, et al, 2020; Newsome et al, 2018); however, several studies have shown that Black women of higher socioeconomic status are still vulnerable to HIV infection, and this vulnerability is even higher while in college due to environmental and cultural influences (Chandler, Guillaume, et al, 2020; Heath, 2016; Newsome et al, 2018). Factors such as high socioeconomic status and education offer the impression that Black women of the middle class are less vulnerable to HIV compared with Black women of a lower socioeconomic status, yet little is known about HIV vulnerability among college-age Black women (Caldwell & Mathews, 2015; Chandler, Guillaume, et al, 2020; Fray & Caldwell, 2017; Painter et al, 2012). This assumption may lead to missed opportunities for HIV and STI prevention and testing within health care settings, including access to PrEP (Chandler, Guillaume, et al, 2020).…”

“…Factors such as high socioeconomic status and education offer the impression that Black women of the middle class are less vulnerable to HIV compared with Black women of a lower socioeconomic status, yet little is known about HIV vulnerability among college-age Black women (Caldwell & Mathews, 2015; Chandler, Guillaume, et al, 2020; Fray & Caldwell, 2017; Painter et al, 2012). This assumption may lead to missed opportunities for HIV and STI prevention and testing within health care settings, including access to PrEP (Chandler, Guillaume, et al, 2020). Black women of higher education levels and socioeconomic status are less likely to screen for HIV and STIs due to having a low perception of HIV risk among themselves, as well as HCPs having a low perception of women's risk (Chandler, Guillaume, et al, 2020).…”

“…This assumption may lead to missed opportunities for HIV and STI prevention and testing within health care settings, including access to PrEP (Chandler, Guillaume, et al, 2020). Black women of higher education levels and socioeconomic status are less likely to screen for HIV and STIs due to having a low perception of HIV risk among themselves, as well as HCPs having a low perception of women's risk (Chandler, Guillaume, et al, 2020). Ultimately, limiting HIV prevention to only women from lower socioeconomic status can be of great detriment to all Black women because Black women have smaller sexual networks and there is a higher prevalence of HIV and STIs within Black communities in the United States (Chandler, Guillaume, et al, 2020; Newsome et al, 2018).…”