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

Cene-Kush, Clare Joan (2012)

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

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