Identifying Predictors of Human Papillomavirus Acquisition Using the Theory of Gender and Power 公开

Abstract

Objectives: This paper seeks to identify behavioral and psychosocial predictors of Human Papillomavirus (HPV) acquisition in a cohort of single, African American women ages 18 to 29. The Theory of Gender and Power was used to select variables and structure analyses.

Methods: This investigation uses secondary analysis of existing data from a behavioral Randomized Control Trial focused on reducing sexual risk behavior and incidence of sexually transmitted infections (STIs) in a cohort of 18-29 year-old African American women using services at three Kaiser Permamente clinics in Atlanta, GA. The Theory of Gender and Power (TGP) was used to select predictor variables and structure analyses, and HPV acquisition over the 12 month follow-up was used as the outcome variable. Potential predictor variables were analyzed using chi-square and t-tests, and variables significant at p<.300 were considered for inclusion in multivariate regressions. Selected variables were assigned to one of the three theoretical constructs or a fourth behavioral category. Significant variables from the first series of regression models were included in a final multivariate logistic regression. Age and experimental condition were controlled for in all regression analyses.

Results: Several variables significantly predicted HPV acquisition in multivariate analysis including consistent condom use, relative partner salary, workplace experiences of sexual harassment, and educational attainment. In the final regression, only consistent condom use significantly predicted HPV acquisition, with consistent condom users being more likely to acquire HPV.

Conclusions: This analysis suggests that TGP is a useful model for considering HPV acquisition. A number of results were contrary to what was expected based on the literature. Substance use, smoking behavior, and partner risk factors did not predict HPV acquisition in this sample, despite strong evidence in the literature linking these factors to HPV infection.

Table of Contents

I.Introduction ................................................1
II.Literature Review ........................................4
Cross-Sectional Studies ..................................4
Longitudinal Studies .......................................9
Theory of Gender and Power ...........................12
III.Materials and Methods ...............................13
Recruitment .................................................13
Data Collection .............................................14
Intervention Methods .....................................14
Measures .....................................................15
Analysis .......................................................21
IV.Results ....................................................22
Sample Description ........................................22
Sexual Behavior Variables ...............................24
Sexual Division of Power Variables ....................25
Sexual Division of Labor Variables .....................25
Structure of Cathexis Variables ........................26
Final Model ...................................................27
V.Discussion .................................................27
Conclusions ..................................................27
Strengths and Limitations ...............................30
Implications and Recommendations ...................31
VI.References ...............................................35
VII.Appendix I - Results of Bivariate Analysis ......43

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 Health Sciences, General Health Sciences, Epidemiology
关键词	African American HPV disease acquisition Theory of Gender and Power women's health condom use Human Papillomavirus
Committee Chair / Thesis Advisor	Diclemente, Ralph Joseph, Emory University
Committee Members	Wingood, Gina M, Emory University Sales, Jessica, Emory University
Partnering Agencies	Hospital or other health care provider National or regional non-profit organization (e.g., American Cancer Society)

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