The Power of Influence: A Study of the Interrelationship Between the Environment and Individual Level Risky Behavior in Detained African American Female Adolescents Open Access

Abstract

Abstract
The Power of Influence: A Study of the Interrelationship Between the Environment and
Individual Level Risky Behavior in Detained African American Female Adolescents

Rates of Sexually Transmitted Diseases (STDs) in the African American female
adolescent community continue to be high with regards to gonorrhea and chlamydia.
When the scope is narrowed to those who are a part of the U.S. Juvenile Justice System
(JJS) those rates grow at an alarming rate. While there has been focus on youth who are
detained, little has been done with regards to the sexual health of detained African
American female adolescents. The purpose of this study was to examine the relationship
of ecological factors that influence condom use and STD status in detained African
American female adolescents to better inform future STD/HIV prevention interventions.

A sample of 145 self-identified detained African American female adolescents
ages 13-17 completed an audio-computer-assisted self-interview survey and provided a
urine sample for STD testing upon arrival at a Metropolitan Regional Youth Detention
Center. Assessments were performed to assess the associations among ecological factors
related to individual behavior (risky sex, drugs and alcohol), psychological well-being,
familial factors, relational factors, peer factors, and community factor influences and their
associations to condom use and STD status.

Findings indicated that peer factors significantly predicted both condom use and
STD status while psychological well-being predicted condom use only. These findings
further suggest that those with high levels of peer norms in support of risky behavior are
more likely to use condoms inconsistently. Similarly, those with high levels of gang
affiliation were more likely to test positive for an STD. Lastly, findings indicate that
those with high stress levels were more likely to use condoms inconsistently. These
results suggest using an ecological approach to future STD prevention interventions
among this population.

Table of Contents

Table of Contents Introduction......................................................................................................................... 1 Literature Review............................................................................................................... 8

Ecological Effects on Adolescent Sexual Risk Behavior................................................... 8

Ecological Influences on Sexual Behaviors in African American Adolescents................. 9

Condom Use in Adolescents ........................................................................................... 11

Risky Sexual Behavior in Detained Adolescents ............................................................ 13

Methods............................................................................................................................. 18 Participants...................................................................................................................... 18 Recruitment and Sample Size......................................................................................... 18 Current Analysis............................................................................................................. 19 Measures....................................................................................................................... 20 Data Analysis.................................................................................................................. 27 Results............................................................................................................................... 31 Description of Sample..................................................................................................... 31 Description of Outcome Variables.................................................................................. 34 Bivariate Associations..................................................................................................... 34 Multivariate Logistic Regression Models......................................................................... 36 Discussion.......................................................................................................................... 39 Limitations...................................................................................................................... 41 Implications and Recommendations............................................................................... 42 Conclusion...................................................................................................................... 43 References......................................................................................................................... 44 Appendix............................................................................................................................ 52

A. Individual Behaviors (Risky Sex, Drugs and Alcohol)............................................... 53

B. Psychological Well-Being........................................................................................... 54 C. Familial Factors......................................................................................................... 55 D. Relational Factors....................................................................................................... 56 E. Peer Factors............................................................................................................... 57 F. Community Factors..................................................................................................... 58 Tables

Table 1: Characteristics of Sexual Behaviors.................................................................. 32

Table 2: Description of Predictor Variables.................................................................... 33

Table 3: Bivariate Associations Condom Use.................................................................. 35

Table 4: Bivariate Associations STD Status.................................................................... 36

Table 5: Multivariate Logistic Regressions to Assess Associations Between Ecological Factors and Condom Use and STD Status...................................................................................................................... 37

Table 6: Further Analyses of Regression Models............................................................ 38

About this Master's Thesis

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School	Rollins School of Public Health
Department	Behavioral Sciences and Health Education
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	Detained African American STD ecological incarcerated adolescent condom female
Committee Chair / Thesis Advisor	Diclemente, Ralph Joseph, Emory University
Committee Members	Lang, Delia L, Emory University Sales, Jessica, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs CDC

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