Associations between Depressive Symptomatology, Religiosity, and Sexual Risk Behaviors Among African American Church Going Women Ages 35-60 Open Access

Abstract

Introduction: Rates for sexually transmitted infections among older individuals have been increasing over recent years, with incidence rates for chlamydia and syphilis almost tripling among adults between the ages of 45 and 65 since 2000. Several personal and social level factors are likely related to engagement in sexual risk behaviors.

Objective: The purpose of this study was to assess whether a relationship exists among depressive symptomatology, individual religiosity, religious social support, and sexual risk behaviors in order to better understand the predictors of engagement in risky behavior.

Methods: This study utilized baseline cross-sectional data from a larger longitudinal faith-based HIV-prevention intervention. Single African American women ages 35-60 who were members of four churches in the Atlanta Metro area were surveyed.

Results: Multivariable analysis suggests depressive symptomatology is marginally associated with condom use and number of sex partners, with those being classified as having high depressive symptomatology being twice as likely to report inconsistent condom use (AOR= 2.1; 95% CI=1.0, 4.4; p=.05), and 1.6 times more likely to have multiple sex partners (AOR=1.6; 95% CI=1.0, 2.7; p=.05). Religious social support is significantly associated with number of sex partners, with individuals classified as having low religious social support being 1.7 times as likely to have multiple sex partners than those with high religious social support (AOR=1.7; 95% CI=1.0-2.9; p=.03). Religious social support was not significantly associated with condom use (p=.35). Strength of individual religious faith was not significantly associated with condom use (p=.51) or number of sex partners (p=.77).

Conclusions: Results support previous literature with respect to depressive symptomatology and social support being associated with likelihood of engaging in risky sexual behaviors. More research is needed to examine the relationship between religiosity and sexual risk behaviors. Additionally, future work could benefit from investigating any interaction effects between religiosity and depressive symptomatology relative to sexual risk taking. Findings have implications for faith-based sexual health education programming among older African American women.

Table of Contents

Background and Significance..........................................................................1

Purpose and Research Questions... .................................................................5 Theoretical Framework...................................................................................6

Literature Review...........................................................................................9

Factors Influencing Sexual Risk Behaviors..........................................................9 Depression's Influence on Risky Sexual Behavior...............................................10 The Role of Social Support..............................................................................12 Religious Community as a Source of Social Support............................................15 Religiosity and Risky Sexual Behaviors..............................................................16

Religious Involvement, Depressive Symptomatology, and Risky Sexual Behaviors...17

Summary......................................................................................................18 Methodology................................................................................................19 Recruitment and Sampling...............................................................................19 Measures.......................................................................................................20 Demographics Variables...................................................................................20

Hypothesized Outcome Variables.......................................................................21

Hypothesized Predictor Variables.......................................................................21

Data Analysis..................................................................................................24 Results.........................................................................................................25 Background and Demographics.........................................................................25 Dependent Variable Descriptive Statistics...........................................................25 Condom Use...................................................................................................25 Number of Sexual Partners...............................................................................26 Independent Variable Descriptive Statistics.........................................................28 Depressive Symptomatology.............................................................................28

Strength of Religious Faith................................................................................29

Religious Social Support....................................................................................29 Bivariate Analysis.............................................................................................30 Condom Use....................................................................................................30 Number of Sexual Partners................................................................................30 Multivariate Analysis.........................................................................................31 Condom Use....................................................................................................31 Number of Sexual Partners................................................................................32 Discussion.....................................................................................................33 Limitations......................................................................................................38 Implications and Future Directions......................................................................40 Conclusion.......................................................................................................41 References.....................................................................................................42 Appendix A.....................................................................................................57

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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	Psychology, Behavioral Religion, General Health Sciences, Mental Health
Keyword	Mental health Depression Social support Sexual health Social Cognitive Theory Religion Depressive symptomatology
Committee Chair / Thesis Advisor	Lang, Delia L, Emory University
Committee Members	Lambert, Danielle N, Emory University Davis, Teaniese , Emory University
Partnering Agencies	Religious-based organization Emory University schools, faculty or affiliated programs

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