HIV Risk Among African American Females: Testing the Theory of Gender and Power

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DESCRIPTION (provided by applicant): The proposed research focuses on African American female adolescents and young adults, a population that is overrepresented in rates of sexually transmitted diseases, including HIV, in the United States. To understand why African American female adolescents and young women are vulnerable to HIV/STDs, contextual factors must be considered. The public health adaptation of the sociological theory of gender and power (TGP) provides a framework of social structural constructs that may be used to model contextual determinants of HIV/STD preventive behavior such as consistent condom use and it is one of the major underlying theoretical frameworks guiding the design of three evidence-based interventions for young women. The TGP describes three structures: the sexual division of labor, the structure of affective attachments and social norms, and the sexual division of power. These are hypothesized to generate acquired risks and individual risk factors for disease. This study seeks to test and validate a structural equation model of the direct and indirect effects of acquired social and relational risks and individual risk factors on consistent condom use among African American female adolescents and young women based on the TGP. The findings will address the NIMH Division of AIDS and Health and Behavior Research goal of HIV prevention research aimed at better-understanding the multiple levels of dyadic, social and structural factors that impact HIV risk. This study is a secondary analysis of data collected during AFIYA, a randomized controlled trial of an HIV prevention maintenance intervention for young African American women, currently funded by NIMH. Behavioral data derived in part from the TGP is being collected from 800 African American young women, ages 15-20. Multiple associations between selected theoretical constructs will be tested using structural equation modeling with the baseline data. The sample will be randomly split into two datasets; one dataset will serve to develop the model and the other dataset will be used to validate the model. Public Health Relevance: An objective of Healthy People 2010 is to increase the proportion of adolescents who abstain from sexual intercourse or use condoms if currently sexually active. To better understand sexual behavior among African American female adolescents and young women it is crucial to account for social and relational influences. An empirical test of how the social structural theory of gender and power predicts condom use can provide insight into how to measure and model the associations among the constructs, extending the utility of a theory that has been used extensively to guide the design of HIV prevention interventions.