Relational correlates of unprotected oral and vaginal sex and among African-American adolescent females.

OBJECTIVES: To identify relational correlates of unprotected oral sex (UOS) and vaginal intercourse (UVI) among African-American females. METHODS: Participants (n=715) provided data on demographics, sexual communication self efficacy (SCSE), sexual communication frequency, condom self-efficacy, power in sexual relationships, fear of negotiating condom use, UOS and UVI. RESULTS: Participants reporting low SCSE were 2.5 and 1.6 times more likely to report UOS and UVI respectively. Additionally, participants who reported fear of condom negotiation were 3.1 times more likely to report UVI. CONCLUSIONS: Interventions promoting stronger SCSE may be a protective factor against having UOS and UVI among African-American females.

Predictors of consistent condom use among young African American women.

The purpose of this study was to determine the predictive value of selected factors to the consistent use of condoms among high-risk young African American women. A clinic-based, prospective, study of 242 young, African-American women (ages 15-21) was conducted. In multivariate analysis, consistent condom use was predicted by having greater perceptions of condom negotiation self-efficacy, lower fear of negotiating condom use, and having communicated with sex partners (during the recall period) about condom use. Relational variables were predictive of consistent condom use among young African American women. STD/HIV preventive interventions should target these factors, perhaps in dyad-level interventions.

African-American female adolescents who engage in oral, vaginal and anal sex: "doing it all" as a significant marker for risk of sexually transmitted infection.

African-American female adolescents who engaged in vaginal sex only (N = 272) were compared to adolescents who engaged in two types (vaginal plus oral or anal; N = 295) and three types (vaginal, oral and anal; N = 144) on a constellation of other sexual risk behaviors (SRBs) and on sexually transmitted infections (STIs). Adjusted contrasts among groups revealed that adolescents who engaged in two and in three types of sex as compared to those who engaged in vaginal sex only were more likely to engage in six of the seven SRBs, but were just as likely to have a STI. One SRB, having >/= 4 lifetime sex partners, was in turn associated with STI. Two-way interactions indicated that having a casual sex partner and having multiple sex partners in the last 60 days increased the likelihood of STI, but only for adolescents who engaged in all three types.

Co-occurrence of intoxication during sex and sexually transmissible infections among young African American women: does partner intoxication matter?

BACKGROUND: The co-occurrence of a behaviour (being intoxicated on alcohol/drugs during sex) with a disease outcome [laboratory-confirmed sexually transmissible infection (STI) prevalence] among young African American women and their male sex partners was studied. METHODS: A cross-sectional study was conducted. Recruitment and data collection occurred in three clinics located in a metropolitan city of the Southern USA. A total of 715 African American adolescent females (15-21 years old) were enrolled (82% participation rate). The primary outcome measure was the analysis of self-collected vaginal swabs using nucleic acid amplification assays for Trichomonas vaginalis, Chlamydia trachomatis, and Neisseria gonorrhoeae. RESULTS: After controlling for age and self-efficacy to negotiate condom use, young women's alcohol/drug use while having sex was not significantly associated with STI prevalence [adjusted odds ratios (AOR) = 1.29, 95% confidence interval (CI) = 0.90-1.83]. However, using the same covariates, the association between male partners' alcohol/drug use and sexually transmitted disease prevalence was significant (AOR = 1.44, 95% CI = 1.03-2.02). Young women reporting that their sex partners had been drunk or high while having sex (at least once in the past 60 days) were approximately 1.4 times more likely to test positive for at least one of the three assessed STIs. CONCLUSION: Young African American women reporting a male sex partner had been intoxicated during sex were significantly more likely to have an STI. The nature of this phenomenon could be a consequence of women's selection of risky partners and lack of condom use possibly stemming from their intoxication or their partners' intoxication.

Meaning making in mothers' and children's narratives of emotional events.

Narrative coherence and the inclusion of mental state language are critical aspects of meaning making, especially about stressful events. Mothers and their 8- to 12-year-old children with asthma independently narrated a time they were scared, frustrated, and happy. Although mothers' narratives were generally more coherent and more saturated with mental state language than children's narratives, for both mothers and children narratives of negative events were more coherent and contained more mental state language than narratives of positive events overall, and narratives of scary events contained more mental state language than narratives of frustrating events. Coherence appears to be multifaceted, in that the three dimensions of coherence coded, context, chronology, and theme were not strongly interrelated within narratives of the same event, but use of mental state language, including cognitive-processing and emotion words, appears to be more integrated. Moreover, while thematic coherence seems to be a consistent individual narrative style across valence of event being narrated, mental state language appears to be a consistent style only across the two stressful event narratives. Finally, and quite surprisingly, there were virtually no relations between mothers' and children's narrative meaning making.

Sexual agency versus relational factors: a study of condom use antecedents among high-risk young African American women.

BACKGROUND: The influence that female partners exert regarding condom use is not well known. In the present study, the relative roles of personal sexual agency and relational factors in determining whether young African American women engaged in unprotected vaginal sex (UVS) were studied. METHODS: A cross sectional study of 713 young, African American women (aged 15-21 years) was conducted. Data were collected using an audio-computer assisted self-interview. Three measures of sexual agency were assessed and three relational factors were assessed. To help assure validity in the outcome measure, condom use was assessed in five different ways. Multivariate analyses were used to determine whether variables independently predicted UVS. RESULTS: Two of the six predictor variables achieved multivariate significance with all five measures of condom use: (1) fear of negotiating condom use with male partners, and (2) indicating that stopping to use condoms takes the fun out of sex. A relational factor (male-dominated power imbalances) achieved multivariate significance for four of the five measures of UVS. A sexual agency factor (whether young women greatly enjoyed sex) achieved multivariate significance for three of the five measures. CONCLUSION: The results suggest that young African American women at high-risk of sexually transmissible infections (STI)/HIV acquisition may experience male-dominated power imbalances and also fear the process of negotiating condom use with their male partners. Although these factors were independently associated with UVS, two factors pertaining to sexual agency of these young women were also important predictors of UVS. Intervention efforts designed to avert STI/HIV acquisition among young African American women should therefore include programs to address both sexual agency and relational factors.