Condom use among young African American women: Modeling and extending the Theory of Gender and Power Open Access

DePadilla, Lara Mireille (2009)

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The three structures of the Theory of Gender and Power (TGP): the sexual division of labor; the structure of affective attachments and social norms (SAASN); and the sexual division of power, are hypothesized to have profound influences on risk for HIV/STDs among African American females. However, relationships between the structures have not been articulated and the processes by which influences with the SAASN affect sexual decision making (SDM) have not explored among African American young women. The goals of this research were to: (1) examine the existing literature to understand how the structures have been linked previously, (2) empirically test the direct and indirect effects of the structures on condom use, and (3) qualitatively explore in depth constructs within the SAASN as influences on SDM. The systematic review indicated variability in the measurement of TGP constructs and a paucity of analyses of mediation. The empirical test of the structures (N=701) provided evidence of direct and indirect associations between condom use and associated social and behavioral risk factors. The qualitative study (N=20) indicated that expectations of relationships varied based on the nature of parental relationships and SDM was related to these expectations. The systematic review and the empirical test of a model of condom use suggest that there are important relationships between TGP structures for interventionists to understand. Exploring processes within SAASN provided insight into how caregivers influence SDM. These findings provide new directions for measuring and modeling TGP constructs.

Table of Contents

CHAPTER 1. Literature Review 1

Introduction . 1

Theoretical Context 2

The Theory of Gender and Power 8

Enhancing the Understanding the Structure of Affective Attachments and Social Norms 27

Significance of Proposed Program of Research . 31

CHAPTER 2: A systematic review of observational and experimental literature: Risk factors described by the Theory of Gender and Power tested as correlates of condom use among African American young women 34

Introduction . 36

Methods 41

Results 44

Discussion 53

Limitations 56

Future Directions 56

CHAPTER 3: Condom use among African American female adolescents and young women: Modeling the Theory of Gender and Power 72

Introduction 74

Methods 79

Results 87

Discussion 90

Limitations 94

Conclusion 95

CHAPTER 4: Relational expectations and sexual risk reduction strategies among African American young women: A qualitative study of the impact of parents and peers . 101

Introduction 103

Methods 106

Results 111

Discussion 131

Conclusion 134

References 136

Appendices 163

Appendix 1. Search Terms 163

Appendix 2. Theory of Gender and Power Bivariate Associations 183

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