African American Adolescent Women Research Articles

Adolescent Experiences of Clinician–Patient HIV/STI Communication in Primary Care

ABSTRACTEffective clinician–patient communication is linked to positive patient health outcomes in adults, yet the research on adolescent populations remains limited. We describe adolescent experiences of clinician–patient HIV/STI communication through qualitative interviews with predominantly African-American adolescent women from a youth-centered primary care clinic. Participants described acknowledging clinicians are professionals, the importance of confidentiality to foster clinician–adolescent communication, and calling for clinician-initiated HIV/STI communication. Adolescents expressed the necessity for clinicians to engage youth in these challenging conversations through an open and understanding approach. Additionally, adolescents described experiences of perceived judgment and uncomfortableness from clinicians, and non-disclosure of HIV/STI risk behaviors to their clinician. Findings underscore the adolescents’ desire to engage in HIV/STI communication with healthcare providers, while highlighting important strategies for clinicians. Results can inform health communication research and practice, and the development of interventions aimed at increasing clinician–adolescent HIV/STI communication.

HIV Risk-Reduction Prevention Interventions Targeting African American Adolescent Women.

African American young women are overwhelmingly disproportionately burdened by HIV/AIDS in the United States today. The purpose of the current systematic review was to identify the characteristics of efficacious HIV risk-reduction prevention interventions targeting African American adolescent women in order to inform future intervention development and expansion. We searched PubMed, PsychInfo, and ProQuest databases for journal articles and dissertations published between 2000 and 2015 reporting the impacts of HIV risk-reduction prevention interventions in the U.S. targeting African American adolescent women under age 25. Twenty articles assessing the efficacy of 12 interventions were eligible for inclusion. Selected interventions represented a total of 5,556 African American adolescent women and primarily drew from self-efficacy and self-empowerment-based theoretical frameworks. One intervention targeted girls under age 13; eight included participants ages 13-17; ten targeted adolescents aged 18-24 years; and five interventions included women over age 24 among their participants. Most interventions consisted of in-person knowledge and skills-based group or individual sessions led by trained African American female health professionals. Three were delivered via personal electronic devices. All programs intervened directly at the individual-level; some additionally targeted mothers, friends, or sexual partners. Overall, efficacious interventions among this population promote gender and ethnic pride, HIV risk-reduction self-efficacy, and skills building. They target multiple socio-ecological levels and tailor content to the specific age range, developmental period, and baseline behavioral characteristics of participants. However, demonstrated sustainability of program impacts to date are limited and should be addressed for program enhancements and expansions.

Sexual risk behavior and STI health literacy among ethnic minority adolescent women

Although information is available for prevention of sexually transmitted infection (STI/HIV), adolescents continue to engage in high risk sexual behavior particularly ethnic minority adolescent women with histories of STI or abuse. A description therefore of STI/HIV knowledge and sexual risk behavior among these women is indicated for modification of prevention efforts for sexual health promotion. African-American (n=94) and Mexican-American (n=465) adolescent women 14–18years of age were included in the study. Assessments of sexual risk behavior and STI/HIV knowledge among these adolescent women described Mexican-American women as at higher risk of STI, pregnancy, substance use and abuse with lower levels of STI/HIV knowledge, previous HIV testing and perceptions of risk than African-American women. A focus on Mexican-American adolescent women with histories of STI and abuse is indicated for translation of community-based health promotion interventions for amelioration of potential adverse sexual health outcomes among ethnic minority adolescent women.

P4.033 Examining Depressive Symptoms and Substance Use in High Risk Mexican American and African American Adolescent Women

BackgroundEvaluate depressive symptoms and substance use among high risk Mexican (MA) and African (AA)-American adolescent women and identify factors associated with substance use to inform development of community-based interventions for...

Sexual concurrency among young African American women

Young African-American women are disproportionately affected by human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) sexually transmitted infections (STI), and engage in greater sexual concurrency than other race/ethnicities. It is important to evaluate behaviors and characteristics associated with the risk of sexual concurrency, so that interventions can target factors most likely to affect positive change. An emphasis on correlates of concurrency beyond individual-level factors has been suggested. The purpose of this study, therefore, was to identify individual- and partner-level characteristics associated with sexual concurrency among high-risk, young African-American women. Data were collected from 570 African-American adolescent women (aged 15–21) recruited from a STI clinic, a family planning clinic, and a teen clinic located in Atlanta, GA from March 2002 through August 2004. Logistic regression analysis was conducted in 2012 to evaluate correlates of sexual concurrency. Results show that almost one-quarter of participants reported sexually concurrent partnerships and 28.4% suspected male partner concurrency. Logistic regression results indicated the number of lifetime sexual partners and relationship factors were the primary contributors to engaging in concurrency in this sample. These findings suggest relationship factors may be important contributors to the prevalence of sexual concurrency among young African-American women. Interventions targeted toward sexual health among young African-American women may need to specifically address partner/relationship factors. Through these findings, we hope to better understand sexual risk taking and develop strategies that would overcome barriers to existing interventions aimed at improving the sexual health outcomes of young African-American women.

Arousability as a predictor of sexual risk behaviours in African-American adolescent women

This study examined the impact of sexual excitation (arousability) on sexual risk-taking behaviours in a community sample of African-American adolescent women. A sample of 701 African-American adolescent women completed measures examining their propensity for sexual arousal, impulsivity and sexual behaviour. Compared with women with a lower propensity for sexual arousability, women with a higher propensity reported a greater number of sexual partners, more inconsistent condom use, a greater likelihood of having engaged in sexual intercourse with 'risky' partners, and sex while high on alcohol or drugs. These results indicate that women who have a greater propensity to become sexually aroused in a variety of situations may be at a greater risk for contracting HIV or sexually transmissible infections relative to women with a lower propensity for arousal. This suggests that individual differences in the propensity to become sexually aroused should be considered when developing intervention approaches targeting young African-American women.

Predictors of repeat Chlamydia trachomatis and/or Neisseria gonorrhoeae infections among African-American adolescent women

BackgroundYoung African-American women have the highest rates of Chlamydia trachomatis and Neisseria gonorrhoeae in the USA. The objective was to identify baseline predictors of repeat chlamydia and/or gonorrhoea infections among...

Sexual Victimization and Family Violence Among Urban African American Adolescent Women

Guided by an intersectional feminist perspective, we examined sexual victimization, witnessing intimate partner violence (IPV) in the family, and familial physical abuse among a sample of 180 urban African American adolescent women. We used cluster analysis to better understand the profiles of cumulative victimization, and the relationships between profiles and IPV victimization and personal exposure to the sex trade. Just under one third of the sample reported sexual victimization, with cooccurrence with both forms of family violence common. The cluster profile with high levels of severe family violence was associated with the highest rate of IPV victimization and sex trade exposure.

Adapting an Evidence-Based HIV Intervention for At-Risk African American College Women at Historically Black Colleges and Universities Who Use Alcohol and Drugs

The convergence of the high prevalence of HIV incidence among African American adolescent and adult women along with substance use and risky sexual behavior among university students necessitates the development of a HIV intervention specifically addressing culture, gender, and college factors for female African American university students. The woman-focused HIV intervention was chosen for adaptation because it has been shown to be efficacious with reducing risk for African American women who use alcohol and drugs, and has been successfully adapted 7 times. The target population was African American college women enrolled at a historically Black university who use alcohol and other drugs, and who engaged in risky sex behaviors. To understand and assess the needs of this population, we conducted four focus groups with African American college women, two in-depth interviews with faculty, and a combination of in-depth interviews and focus groups with student affairs and health staff that were analyzed using content analysis. From this analysis, several themes emerged that were used to adapt the intervention. Emerging themes included challenges related to identity and societal stereotypes, lack of knowledge about sexual health (i.e., negotiating safer sex) and the function of female and male anatomies, high incidents of pregnancy, negative consequences related to alcohol and marijuana use, and the need to incorporate testimonies from college students, media enhancements, and role-plays to convey intervention messages. After the preliminary adaptation, 11 college women reviewed the adapted intervention and provided positive feedback. Plans for future research are discussed.

Conceptualization of sexual partner relationship steadiness among ethnic minority adolescent women: implications for evidence-based behavioral sexual risk reduction interventions.

Cognitive behavioral interventions for sexual risk reduction have been less successful among ethnic minority adolescent women with histories of abuse and sexually transmitted infections (STI) than among other adolescent populations. African American and Mexican American adolescent women (ages 14-18 years, n = 548) self-reported sexual partner relationship steadiness and sexual risk behaviors via semi-structured interviews at study entry. Descriptive and bivariate analyses compared sexual risk behaviors by sexual partner relationship steadiness. Steady and unsteady relationships were conceptualized differently. Steady relationships included emotional or financial support, sexual communication, greater relationship importance, unintended pregnancy, and perceived monogamy during break-ups. Unsteady relationships were unpredictable, including sex with ex-steady partners and friends with benefits, lack of mutual respect, and poor sexual communication. Modification of sexual risk reduction interventions including conceptualizations of risk by context of sexual partner relationship status is recommended to enhance efficacy among minority adolescent women with STI or history of abuse.

Cash, Cars, and Condoms: Economic Factors in Disadvantaged Adolescent Women's Condom Use

Evaluate whether adolescent women who received economic benefits from their boyfriends were more likely never to use condoms. Data are obtained from a longitudinal HIV prevention intervention study with 715 African American adolescent women in urban Atlanta surveyed at baseline, 6 months, and 12 months. The primary outcome was never using condoms in the past 14 and 60 days at 6 and 12 months. The primary predictor was having a boyfriend as primary spending money source at baseline. Analysis minimized confounding using propensity weighting to balance respondents on 81 variables. A boyfriend was the primary spending money source for 24% of respondents, who did not differ in neighborhood or family context but had lower education, more abuse history, riskier sex, and more sexually transmitted infections. After propensity score weighting, no statistically significant differences for 81 evaluated covariates remained, including age distributions. Women whose boyfriend was their primary spending money source were 50% more likely never to use condoms at 6 and 12 months and less likely to respond to the intervention at 12 months. Women whose boyfriend had been their primary spending money source but found another spending money source were more likely to start using condoms than women who continued. Women whose boyfriends owned cars were more likely never to use condoms. Receiving spending money from a boyfriend is common among adolescent women in populations targeted by pregnancy and sexually transmitted infection prevention interventions, and may undermine interventions' effectiveness. Clinicians and reproductive health interventions need to address females' economic circumstances.

P2-S9.13 African- and Mexican-American adolescent women with sti and a history of abuse: biological outcome of a randomised trial of behavioural intervention

BackgroundTo implement a randomised trial of a risk-reduction intervention consisting of small group sessions, individual counselling and support groups for African- and Mexican-American adolescent women with STI and abuse history...

Chronic kidney disease in cats: An ounce of prevention is worth a pound of cure

Although information is available for prevention of sexually transmitted infection (STI/HIV), adolescents continue to engage in high risk sexual behavior particularly ethnic minority adolescent women with histories of STI or abuse. A description therefore of STI/HIV knowledge and sexual risk behavior among these women is indicated for modification of prevention efforts for sexual health promotion. African-American (n = 94) and Mexican-American (n = 465) adolescent women 14–18 years of age were included in the study. Assessments of sexual risk behavior and STI/HIV knowledge among these adolescent women described Mexican-American women as at higher risk of STI, pregnancy, substance use and abuse with lower levels of STI/HIV knowledge, previous HIV testing and perceptions of risk than African-American women. A focus on Mexican-American adolescent women with histories of STI and abuse is indicated for translation of community-based health promotion interventions for amelioration of potential adverse sexual health outcomes among ethnic minority adolescent women.

Employing a teen advisory board to adapt an evidence-based HIV/STD intervention for incarcerated African-American adolescent women

This manuscript assesses priorities and challenges of adolescent females by conducting a meeting with teen advisory board (TAB) members to collect information regarding their lives and experiences pre-, during and post-incarceration in a juvenile detention facility. Multiple themes emerged regarding the impact of incarceration on young African-American females, including experiencing a loss of personal liberties, the importance of making money upon release, unfaithfulness by partners on the 'outside', substance use and lack of control over their environment upon release, including parents, peers and male sexual partners. Based on feedback from TAB members, unique barriers and challenges were identified that suggested areas where adaptations to an evidenced-based HIV/sexually transmitted disease (STD) intervention would be justified to more adequately meet the needs of this particular subgroup of young African-American women. Adaptations to the evidence-based interventions included enhancing activities related to goal setting, emotion regulation skills, decision-making, recognizing and utilizing support networks and addressing the relationship between substance use and risky sexual behavior. Future health education efforts focusing on either the creation of new HIV/STD interventions or adaptations to existing interventions should consider utilizing advisory boards with members of the priority population at the earliest stages of intervention planning.

Context of sexual risk behaviour among abused ethnic minority adolescent women

Evidence suggests that multiple influences on sexual behaviour of adolescents exist, ranging from relationships with significant others including sexual or physical abuse and childhood molestation to substances used prior to sex and environmental circumstances such as sex work. This study aims to describe associations between childhood molestation and sexual risk behaviour. African American and Mexican American adolescent women aged 14-18 years (n=562) with sexually transmitted infection (STI) or abuse histories and enrolled in a randomized controlled trial of behavioural interventions were interviewed via self-report concerning sexual risk behaviour, abuse and childhood molestation at study entry. Sexual (59%), physical (77%) and psychological (82%) abuse and childhood molestation (25%) were self-reported without differences by ethnicity. Adolescents reporting childhood molestation experienced more forms of sexual, physical and psychological abuse than others and higher incidences of STI. Fewer attended school; however, more had arrests, convictions, incarcerations and probations. Stressors including depression, running away, thoughts of death and suicide were highest for those reporting childhood molestation. Those reporting childhood molestation engaged in higher sexual risk behaviours than adolescents experiencing other forms of sexual or physical abuse (lifetime partners, bisexual relationships, anal and group sex, sex with friends with benefits, sex for money, concurrent partners, drug use including multiple substances, alcohol use and alcohol problems). These adolescents reported 'getting high' and having sex when out of control as reasons for sex with multiple partners. Interventions for abused adolescent women necessitate a focus on associations between childhood molestation and a multiplicity of sexual risk behaviours for prevention of abuse, substance use and sex work, STI/human immunodeficiency virus (HIV) and sequelae.

Development of the Sexual Sensation-Seeking Scale for African American Adolescent Women

ABSTRACT We used data derived from two independent studies to examine the psychometric properties of a new scale to measure adolescents’ willingness to engage in sexual sensation-seeking behavior. In Study 1, the Sexual Sensation-Seeking Scale for Adolescents (SSSA) was administered to a sample of 715 African American adolescents ranging in age from 15 to 21 years. The SSSA demonstrated strong internal consistency, moderate stability, and satisfactory construct validity. In Study 2, the SSSA data from a subsample of African American adolescent women detained in youth detention centers were analyzed (N = 103). Strong internal consistency was demonstrated with this sample as well. The results indicate that the SSSA is a reliable and valid measure of sexual sensation seeking for African American adolescent women.

Emotional Victimization and Sexual Risk-Taking Behaviors Among Adolescent African American Women

Previous research has demonstrated that a history of gender-based victimization is associated with higher rates of sexual risk-taking behaviors among adolescents. Victimization can occur in various forms. To date, no published studies have examined the relationship between the different forms of victimization and sexual risk-taking behaviors among African American adolescent women. This study explored the association between different forms of victimization and sexual risk behaviors using baseline data from participants (N = 715) with a mean age of 17.9 (SD = 1.7), who were enrolled in a larger intervention study. The results revealed that a history of any form of victimization was associated with some form of sexual risk behaviors.

African American Women's Retrospective Perceptions of the Intergenerational Transfer of Gynecological Health Care Information Received From Mothers: Implications for Families and Providers

Seeking preventive care and communicating openly with providers during clinical encounters could reduce adolescent African American (AA) women's risk of acquiring STIs or HIV. This study examines how the intergenerational transfer of gynecological health care information between mothers and daughters may influence the health care-seeking behavior of AA adolescent women and their ability to speak openly with providers about sexual health concerns, including sexually transmitted infection (STI) and HIV prevention during clinical encounters. In-depth interviews were conducted with 17 AA women (ages 20–55) to elicit retrospective narrative accounts including reason for the first visit, decision to seek care, and mother-daughter communication regarding gynecological health care. Data were analyzed using Critical Incident Analysis (CIA). Most participants (70%) sought gynecological health care as adolescents based upon their mothers' recommendations. Many (59%) reported that the visit was not preventive. Participants (29%) reported that a lack of communication from mothers regarding gynecological health was critical to their ability to speak openly with providers. Knowledge gained from this study could increase mothers' as well as providers' ability to facilitate family gynecological health communication, which could decrease young women's risk of experiencing negative health outcomes including HIV.

Perspectives on Focus Group Participation and Remuneration

Recruiting participants from underserved and marginalized communities for behavioral research is an essential yet challenging task. We examined participants' motivation to participate in a focus group about health communication and their beliefs about appropriate remuneration for participation. Twelve focus groups were conducted with low-income African American and Latina adolescent girls and African American women. We utilized a grounded theory approach and thematic analysis to examine views about research participation and remuneration. This study can inform important considerations about the consent process, study recruitment, and remuneration.

Genetic and environmental contributions to BMI in adolescent and young adult women.

The objective of this study was to determine the genetic and environmental contributions to variation in BMI over time in European-American (EA) and African-American (AA) adolescent and young adult women. Self-reported BMI (kg/m(2)) data from 2,816 EA (1,306 twin pairs, 56.5% monozygotic (MZ)) and 404 AA (178 twin pairs, 42.7% MZ) women at baseline (T1; median age 15 years) and 3,225 EA (1,511 twin pairs, 55.3% MZ) and 539 AA (252 pairs, 43.3% MZ) women at follow-up (T2; median age 22 years) from a Midwestern US, population-based twin registry were used to construct biometrical genetic models. For EA women, the majority of the variance in BMI was attributable to additive genetic effects at both time points (82% for each), with the remaining variance attributable to nonshared environment. Genetic and nonshared environment correlations between adolescent and young adult BMI were 0.87 and 0.23, respectively. Among AA women, nonadditive genetic effects comprised 68% of the variance at T1 and 73% at T2, and were highly correlated (r(D) = 0.94). The proportions of variance attributable to nonshared environment at T1 (29%) and T2 (25%) were more modestly correlated (r(E) = 0.31). The remaining variance in AA women could be attributed to additive genetic effects. Additive vs. nonadditive genetic effects contribute differentially to BMI in AA vs. EA adolescent and young adult women. Additional research is needed to better characterize the environmental and genetic factors related to BMI in persons of different races to aid understanding of the complex determinants of body weight in individuals.