Social Cognitive Correlates of HIV-associated Sexual Risk Behavior Among African-American Adult Women Open Access

Cene-Kush, Clare Joan (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/f1881m02w?locale=en
Published

Abstract


Abstract
Social Cognitive Correlates of HIV-associated Sexual Risk Behavior
Among African-American Adult Women
Purpose: African American adult women are disproportionately burdened by sexual y-transmitted
infections (STIs) including HIV/AIDS. Guided
Cognitive Theory, this study investigated
the association of individual- and environmental-level factors with HIV-associated sexual risk
behavior among a low-income, high-risk sample of adult African American women. Methods: A
secondary analysis of data col ected for the cross-sectional HVARC study was performed to
determine relationships between salient social cognitive constructs and the outcome variables:
number of lifetime vaginal sex partners, frequency of vaginal sex in the previous 30 days, and
consistent condom use. Participants were African American adult females (N = 321, mean age =
27.4) recruited from a family planning clinic in Atlanta, GA who completed an audio-computer
assisted self-interview. Results: Results demonstrated a high prevalence of inconsistent condom use
and history of positive STI test result. In hierarchical linear regression analyses, greater self-efficacy
for refusal of sexual intercourse (an individual-level factor) was associated with reporting fewer
lifetime vaginal sex partners and peer norms supportive of high-risk sexual behavior (an
environmental-level factor) was associated with reporting a greater number lifetime vaginal sex
partners. Relative to the environmental-level determinant, peer norms, the individual determinant
self-efficacy for sex refusal accounted for a greater amount of the variance in number of lifetime
vaginal sex partners. Self-efficacy for partner communication and future orientation were not
significantly associated with sexual risk behavior. Conclusions: Results of this cross-sectional study
indicate that the efficacy of culturally-tailored, gender-specific STI/HIV prevention programs for
African American adult women may be improved via the inclusion of components which increase
self-efficacy for sex refusal and target peer norms regarding sexual behavior. Future studies should
prospectively examine the relationship between self-efficacy for sex refusal, peer norms supportive
of unsafe sex and sexual risk behavior among this high-risk group.

Table of Contents



Table of Contents
Chapter 1: Introduction

................................................................................................................ 1
Problem Definition .......................................................................................................................1
Theoretical Framework ................................................................................................................2
Purpose of the Study .....................................................................................................................8
Research Questions & Hypotheses ..............................................................................................9
Chapter 2: Literature Review ..................................................................................................... 10
STIs/HIV Among Adult African American Women ....................................................................10
Self-efficacy for Partner Communication ..................................................................................13
Self-efficacy for Sex Refusal .......................................................................................................20
Positive Future Orientation .......................................................................................................24
Peer Norms Supportive of High-Risk Sexual Behavior ..............................................................28
Chapter 3: Methods ..................................................................................................................... 31
Participants ................................................................................................................................31
Measures ....................................................................................................................................31
Procedure ...................................................................................................................................35
Data Analysis Plan .....................................................................................................................36
Chapter 4: Results........................................................................................................................ 38
Demographic Characteristics ....................................................................................................38
Distribution of SCT variables ....................................................................................................38
Distribution of Sexual Risk-taking Outcome Variables .............................................................39
Covariates ..................................................................................................................................39
Hypothesis 1 ...............................................................................................................................41
Hypothesis 2 ...............................................................................................................................41
Hypothesis 3 ...............................................................................................................................42
Hypothesis 4 ...............................................................................................................................42
Hypothesis 5 ...............................................................................................................................44
Chapter 5: Discussion .................................................................................................................. 44
Discussion of Findings ...............................................................................................................44
Limitations ..................................................................................................................................51
Implications ................................................................................................................................52



Directions for Future Research ..................................................................................................53
Appendix 1. Scale Information

................................................................................................... 55
Figure 1: Theoretical Framework .............................................................................................. 56
Tables ............................................................................................................................................ 57
Table 1: Demographic information ..........................................................................................57
Table 2: Distribution of SCT independent variables .................................................................58
Table 3: Distribution of sexual risk-taking outcome variables ..................................................58
Table 4: Bivariate associations between SCT variables and continuous-level sexual risk-taking
outcome variables .....................................................................................................................59

Table 5: Bivariate associations between SCT variables and dichotomous-level sexual risk-
taking outcome variables ...........................................................................................................60

Table 6: Hierarchical regression of self-efficacy for sex refusal and control variables on
number of lifetime vaginal sex partners .....................................................................................61

Table 7: Hierarchical regression of peer norms supportive of high-risk sexual behavior and
control variables on number of lifetime vaginal sex partners ...................................................61

Table 8: Hierarchical regression of peer norms supportive of high-risk sexual behavior and
control variables on frequency of vaginal sex in previous 30 days ..........................................62

Table 9: Hierarchical regression of self-efficacy for sex refusal, peer norms and control
variables on number of lifetime vaginal sex partners ................................................................62

References ..................................................................................................................................... 63

About this Master's Thesis

Rights statement
  • Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.
School
Department
Degree
Submission
Language
  • English
Research field
Keyword
Committee Chair / Thesis Advisor
Committee Members
Partnering Agencies
Last modified

Primary PDF

Supplemental Files