When a relationship is imperative, will young women knowingly place their sexual health at risk? A sample of African American adolescent girls in the juvenile justice system
Jerris L. Raiford A F , Puja Seth A B , Amy M. Fasula A C and Ralph J. DiClemente D EA Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, 1600 Clifton Road NE, Mailstop E-59, Atlanta, GA 30333, USA.
B Present address: Division of Unintentional Injury Prevention, 4770 Buford Highway NE, MS F-62, Atlanta, GA 30341-3717, USA.
C Division of Reproductive Health, 4770 Buford Highway, MS F74, Atlanta, GA 30341-3717, USA.
D Emory University, Rollins School of Public Health, Department of Behavioral Sciences & Health Education, 1518 Clifton Road, Atlanta, GA 30322, USA.
E Center for AIDS Research, Social & Behavioral Science Core, 201 Dowman Drive, Atlanta, GA 30322, USA.
F Corresponding author. Email: jraiford@cdc.gov
Sexual Health 14(4) 331-337 https://doi.org/10.1071/SH16160
Submitted: 7 September 2016 Accepted: 14 February 2017 Published: 27 April 2017
Abstract
Background: HIV and other sexually transmissible infections (HIV/STIs) are significant contributors to adolescent girls’ morbidity in the US. Risks for HIV/STIs are increased among adolescent girls involved in the juvenile justice system, and African American adolescent girls comprise nearly 50% of adolescent girls in detention centres. Although HIV prevention programs focus on HIV/STI knowledge, increased knowledge may not be sufficient to reduce sexual risk. The present study examined the interactive effects of HIV/STI knowledge and the importance of being in a relationship (a relationship imperative) on sexual risk behaviours in a sample of detained African American adolescent girls. Methods: In all, 188 African American adolescent girls, 13–17 years of age, were recruited from a short-term detention facility in Atlanta, Georgia, and completed assessments on sexual risk behaviours, relationship characteristics, HIV/STI knowledge and several psychosocial risk factors. Results: When girls endorsed a relationship imperative, higher HIV/STI knowledge was associated with low partner communication self-efficacy, inconsistent condom use and unprotected sex, when controlling for demographics and self-esteem. Conclusions: Young girls with high HIV/STI knowledge may have placed themselves at risk for HIV/STIs given the importance and value they place on being in a relationship. Contextual factors should be considered when developing interventions.
Additional keywords: condom use, detention, detained, HIV/STI, incarcerated, knowledge.
References
[1] Centers for Disease Control and Prevention. Youth risk behavior surveillance – United States, 2013. MMWR Morb Mortal Wkly Rep 2014; 63 1–172.[2] Whitmore SK, Kann L, Prejean J, Koenig LJ, Branson BM, et al Vital signs: HIV infection, testing, and risk behaviors among youths – United States. MMWR Morb Mortal Wkly Rep 2012; 61 971–6.
[3] Centers for Disease Control and Prevention (CDC). Reported STDs in the United States: 2012 national data for chlamydia, gonorrhea, and syphilis. Atlanta, GA: CDC; 2014. Available online at: https://www.cdc.gov/std/stats12/std-trends-508-2012.pdf [verified 22 March 2017.
[4] Forhan SE, Gottlieb SL, Sternberg MR, Xu FJ, Datta SD, McQuillan GM, et al Prevalence of sexually transmitted infections among female adolescents aged 14 to 19 in the United States. Pediatrics 2009; 124 1505–12.
| Prevalence of sexually transmitted infections among female adolescents aged 14 to 19 in the United States.Crossref | GoogleScholarGoogle Scholar |
[5] Hockenberry S, Puzzanchera C. Delinquency cases in juvenile court, 2011. Pittsburgh, PA: Office of Juvenile Justice and Delinquency Preventions; 2014.
[6] Tolou-Shams M, Stewart A, Fasciano J, Brown LK. A review of HIV prevention interventions for juvenile offenders. J Pediatr Psychol 2010; 35 250–61.
| A review of HIV prevention interventions for juvenile offenders.Crossref | GoogleScholarGoogle Scholar |
[7] Lederman CS, Dakof GA, Larrea MA, Li H. Characteristics of adolescent females in juvenile detention. Int J Law Psychiatry 2004; 27 321–37.
| Characteristics of adolescent females in juvenile detention.Crossref | GoogleScholarGoogle Scholar |
[8] Chesney-Lind M, Sheldon RG. Girls, delinquency, and juvenile justice. Pacific Grove, CA: Brooks/Cole; 1998.
[9] Robertson AA, Thomas CB, St Lawrence JS, Pack R. Predictors of infection with chlamydia or gonorrhea in incarcerated adolescents. Sex Transm Dis 2005; 32 115–22.
| Predictors of infection with chlamydia or gonorrhea in incarcerated adolescents.Crossref | GoogleScholarGoogle Scholar |
[10] Robertson AA, St Lawrence J, Morse DT, Baird-Thomas C, Liew H, Gresham K. The Healthy Teen Girls Project: comparison of health education and STD risk reduction intervention for incarcerated adolescent females. Health Educ Behav 2011; 38 241–50.
| The Healthy Teen Girls Project: comparison of health education and STD risk reduction intervention for incarcerated adolescent females.Crossref | GoogleScholarGoogle Scholar |
[11] Snyder H, Sickmund M. Juvenile offenders and victims: 2006 national report. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Office of Juvenile Justice and Delinquency Prevention; 2006.
[12] DiClemente RJ, Wingood GM, Crosby RA, Sionean C, Cobb BK, Harrington K, et al Sexual risk behaviors associated with having older sex partners: a study of black adolescent females. Sex Transm Dis 2002; 29 20–4.
| Sexual risk behaviors associated with having older sex partners: a study of black adolescent females.Crossref | GoogleScholarGoogle Scholar |
[13] Pulerwitz J, Amaro H, De Jong W, Gortmaker SL, Rudd R. Relationship power, condom use and HIV risk among women in the USA. AIDS Care-Psychol Socio-Med Asp AIDS/HIV 2002; 14 789–800.
| Relationship power, condom use and HIV risk among women in the USA.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3s%2FgsFGisw%3D%3D&md5=4ac59560898a66fd043b18f1fae5f1f5CAS |
[14] Centers for Disease Control and Prevention. HIV surveillance report, 2013. Volume 25. 2015. Available online at: https://www.cdc.gov/hiv/pdf/library/reports/surveillance/cdc-hiv-surveillance-report-2013-vol-25.pdf [verified 6 March 2015].
[15] Harter S. The construction of the self. New York: Guilford; 1999.
[16] Davila J, Steinberg S, Kachadourian L, Cobb R, Fincham F. Romantic involvement and depressive symptoms in early and late adolescence: the role of a preoccupied relational style. Pers Relatsh 2004; 11 161–78.
| Romantic involvement and depressive symptoms in early and late adolescence: the role of a preoccupied relational style.Crossref | GoogleScholarGoogle Scholar |
[17] Zimmer-Gembeck MJ, Siebenbruner J, Collins WA. Diverse aspects of dating: associations with psychosocial functioning from early to middle adolescence. J Adolesc 2001; 24 313–36.
| Diverse aspects of dating: associations with psychosocial functioning from early to middle adolescence.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MvivFKitQ%3D%3D&md5=973907fca9051fdbb779cf52b7841227CAS |
[18] Zimmer-Gembeck MJ, Siebenbruner J, Collins WA. A prospective study of intraindividual and peer influences on adolescents’ heterosexual romantic and sexual behavior. Arch Sex Behav 2004; 33 381–94.
| A prospective study of intraindividual and peer influences on adolescents’ heterosexual romantic and sexual behavior.Crossref | GoogleScholarGoogle Scholar |
[19] Furman W, Wehner EA. Adolescent romantic relationships: a developmental perspective. In Shulman S, Collins WA, editors. Romantic relationships in adolescence: developmental perspectives. San Francisco: Jossey-Bass; 1997. pp. 21–36.
[20] Banister EM, Jakubec SL, Stein JA. ‘Like what am I supposed to do?’: adolescent girls’ health concerns in their dating relationships. Can J Nurs Res 2003; 35 16–33.
[21] Teitelman AM, Bohinski JM, Boente A. The social context of sexual health and sexual risk for urban adolescent girls in the United States. Issues Ment Health Nurs 2009; 30 460–9.
| The social context of sexual health and sexual risk for urban adolescent girls in the United States.Crossref | GoogleScholarGoogle Scholar |
[22] Banister E, Schreiber R. Young women’s health concerns: revealing paradox. Health Care Women Int 2001; 22 633–47.
| Young women’s health concerns: revealing paradox.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38zpt1agtw%3D%3D&md5=bafb7a3597749210be730b700a017224CAS |
[23] Raiford JL, DiClemente RJ, Wingood GM. Effects of fear of abuse and possible STI acquisition on the sexual behavior of African American adolescent girls and young women. Am J Public Health 2009; 99 1067–71.
| Effects of fear of abuse and possible STI acquisition on the sexual behavior of African American adolescent girls and young women.Crossref | GoogleScholarGoogle Scholar |
[24] Van Roosmalen E. Forces of patriarchy: adolescent experiences of sexuality and conceptions of relationships. Youth Soc 2000; 32 202–27.
| Forces of patriarchy: adolescent experiences of sexuality and conceptions of relationships.Crossref | GoogleScholarGoogle Scholar |
[25] Guerrero LK, Andersen PA, Afifi WA. Close encounters: communication in relationships, 2nd edn. Thousand Oaks, CA: Sage Publications; 2007.
[26] Raiford JL, Seth P, DiClemente RJ. What girls won’t do for love: human immunodeficiency virus/sexually transmitted infections risk among young African-American women driven by a relationship imperative. J Adolesc Health 2013; 52 566–71.
| What girls won’t do for love: human immunodeficiency virus/sexually transmitted infections risk among young African-American women driven by a relationship imperative.Crossref | GoogleScholarGoogle Scholar |
[27] Bryan A, Aiken LS, West SG. HIV/STD risk among incarcerated adolescents: optimism about the future and self-esteem as predictors of condom use self-efficacy. J Appl Soc Psychol 2004; 34 912–36.
| HIV/STD risk among incarcerated adolescents: optimism about the future and self-esteem as predictors of condom use self-efficacy.Crossref | GoogleScholarGoogle Scholar |
[28] Danielson CK, Walsh K, McCauley J, Ruggiero KJ, Brown JL, Sales JM, et al HIV-related sexual risk behavior among African American adolescent girls. J Womens Health (Larchmt) 2014; 23 413–9.
| HIV-related sexual risk behavior among African American adolescent girls.Crossref | GoogleScholarGoogle Scholar |
[29] Swenson RR, Rizzo CJ, Brown LK, Vanable PA, Carey MP, Valois RF, et al HIV knowledge and its contribution to sexual health behaviors of low-income African American adolescents. J Natl Med Assoc 2010; 102 1173–82.
| HIV knowledge and its contribution to sexual health behaviors of low-income African American adolescents.Crossref | GoogleScholarGoogle Scholar |
[30] DiClemente RJ, Lanier MM, Horan PF, Lodico M. Comparison of AIDS knowledge, attitudes, and behaviors among incarcerated adolescents and a public school sample in San Francisco. Am J Public Health 1991; 81 628–30.
| Comparison of AIDS knowledge, attitudes, and behaviors among incarcerated adolescents and a public school sample in San Francisco.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3M7ps1yisA%3D%3D&md5=7a0a2e1654a76066506504a46cc8f4caCAS |
[31] DiClemente RJ, Crittenden CP, Rose E, Sales JM, Wingood GM, Crosby RA, et al Psychosocial predictors of HIV-associated sexual behaviors and the efficacy of prevention interventions in adolescents at-risk for HIV infection: what works and what doesn’t work? Psychosomatic Med 2008; 70 598–605.
| Psychosocial predictors of HIV-associated sexual behaviors and the efficacy of prevention interventions in adolescents at-risk for HIV infection: what works and what doesn’t work?Crossref | GoogleScholarGoogle Scholar |
[32] Price MN, Hyde JS. When two isn’t better than one: predictors of early sexual activity in adolescence using a cumulative risk model. J Youth Adolesc 2009; 38 1059–71.
| When two isn’t better than one: predictors of early sexual activity in adolescence using a cumulative risk model.Crossref | GoogleScholarGoogle Scholar |
[33] Montano DE, Kasprzyk D, Taplin SH. The theory of reasoned action and the theory of planned behavior. In Glanz K, Lewis FM, Rimer BK, editors. Health behavior and health education. San Francisco: Jossey-Bass; 1997. pp. 85–112.
[34] Strecher VJ, Rosenstock IM. The health belief model. In Glanz K, Lewis FM, Rimer BK, editors. Health behavior and health education. San Francisco: Jossey-Bass; 1997. pp. 41–59.
[35] DiClemente RJ, Davis TL, Swartzendruber A, Fasula AM, Boyce L, Gelaude D, et al Efficacy of an HIV/STI sexual risk-reduction intervention for African American adolescent girls in juvenile detention centers: a randomized controlled trial. Women Health 2014; 54 726–49.
| Efficacy of an HIV/STI sexual risk-reduction intervention for African American adolescent girls in juvenile detention centers: a randomized controlled trial.Crossref | GoogleScholarGoogle Scholar |
[36] Rosenburg M. Society and the adolescent self-image. Princeton. NJ: Princeton University Press; 1965.
[37] Sikkema K, Kelly J, Winnett R, Solomon L, Cargil V, Roffman R, et al Outcomes of a randomized community-level HIV prevention intervention for women living in 18 low-income housing developments. Am J Public Health 2000; 200 57–63.
[38] Wingood GM, DiClemente RJ. Partner influences and gender-related factors associated with noncondom use among young adult African American women. Am J Community Psychol 1998; 26 29–51.
| Partner influences and gender-related factors associated with noncondom use among young adult African American women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3jsFGrtA%3D%3D&md5=4eb13349dc054e53a569f900ba95c98cCAS |
[39] Wingood GM, DiClemente RJ. Relationship characteristics and gender-related factors associated with noncondom use among young adult African American women. Am J Community Psychol 1998; 26 29–51.
| Relationship characteristics and gender-related factors associated with noncondom use among young adult African American women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1c3jsFGrtA%3D%3D&md5=4eb13349dc054e53a569f900ba95c98cCAS |
[40] Pulerwitz J, Gortmaker SL, DeJong W. Measuring sexual relationship power in HIV/STD research. Sex Roles 2000; 42 637–60.
| Measuring sexual relationship power in HIV/STD research.Crossref | GoogleScholarGoogle Scholar |
[41] Farrington DP. Predictors, causes and correlates of male youth violence. In Tonry M, Moore MH, editors. Youth violence. Vol. 24. Chicago, IL: University of Chicago Press; 1998. pp. 421–47.
[42] Patterson GR, Reid JB, Dishion TJ. A social learning approach: antisocial boys. Eugene, OR: Castalia; 1992.
[43] Underwood LA, Phillips A, von Dresner K, Knight PD. Critical factors in mental health programming for juveniles in corrections facilities. Int J Behav Consult Ther 2006; 2 107–40.
| Critical factors in mental health programming for juveniles in corrections facilities.Crossref | GoogleScholarGoogle Scholar |
[44] Adimora AA, Schoenbach VJ, Martinson FE, Donaldson KH, Fullilove RE, Aral SO. Social context of sexual relationships among rural African Americans. Sex Transm Dis Aquatic Organisms 2001; 28 69–76.
| Social context of sexual relationships among rural African Americans.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3Mzjsl2jsw%3D%3D&md5=bf177bb92decb4757128c677fa73f22cCAS |
[45] Nunn A, Dickman S, Cornwall A, Kwakwa H, Mayer KH, Rana A, et al Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study. Sex Health 2012; 9 288–96.
| Concurrent sexual partnerships among African American women in Philadelphia: results from a qualitative study.Crossref | GoogleScholarGoogle Scholar |