Associations between Self-Esteem, Partner Communication, and Consistent Condom Use: A Mediation Model for Reducing HIV/STI Related Risk Behaviors Open Access

Lambert, Danielle Nicole (2013)

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Introduction: HIV is a serious pandemic and public health issue, affecting more than 34 million people worldwide. Large disparities exist among African Americans, women, and adolescents with regards to infection rates. Objective: The purpose of this study is to assess whether a relationship exists between self-esteem, partner communication, and consistent condom use in order to reduce HIV/STI related risk behaviors. Methods: This study utilized a cross-sectional design to survey African American adolescent females, ages 14-20 years, accessing three sexual health clinics in Atlanta, GA. Results: No significant associations were found between self-esteem and consistent condom use at last sex (p=.056), in the last 90 days (p=.43), or in the last 6 months (p=.22). Significant associations were seen though between self-esteem and communication self-efficacy (p<.001), partner communication frequency (p<.05), and refusal self-efficacy (p<.001). Mediation analyses were conducted for last sex under assumptions of marginal significance. No mediation was found to be present. Ad hoc analyses showed no significant association between self-esteem and proportion condom use at any time point. Conclusions: Results supported previous literature with regards to associations between self-esteem and partner communication. Further research is needed specifically among African American adolescent females with low self-esteem to examine effects on risky sexual behaviors, specifically consistent condom use. Future studies should also take into account other constructs of "self" such as body image and ethnic identity.

Table of Contents

Chapter I: Background and Significance..........1

Chapter II: Literature Review..........10

Chapter III: Methodology..........20

Chapter IV: Results..........32

Chapter V: Discussion..........41


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