Attitudes Towards Relationship Power and Concurrent Sexual Partnerships among African American Adolescents in Baltimore, MD
| dc.contributor.advisor | Hindin, Michelle J. | en_US |
| dc.contributor.committeeMember | Holtgrave, David R. | en_US |
| dc.contributor.committeeMember | Sherman, Susan G. | en_US |
| dc.contributor.committeeMember | Jennings, Jacky M. | en_US |
| dc.creator | Lilleston, Pamela Sherman | en_US |
| dc.date.accessioned | 2014-12-23T04:37:46Z | |
| dc.date.available | 2014-12-23T04:37:46Z | |
| dc.date.created | 2013-12 | en_US |
| dc.date.issued | 2013-10-10 | en_US |
| dc.date.submitted | December 2013 | en_US |
| dc.description.abstract | Background: African American adolescents are disproportionately affected by sexually transmitted infections (STIs) including HIV. A growing body of literature suggests that high rates of sexual concurrency may contribute to African American adolescents’ heightened risk for STIs and that gender role beliefs may be an important driver of this sexual risk behavior. Although a number of studies point to a connection between gender ideology and STI risk, a more detailed picture of the sociocultural and economic context of this relationship has yet to emerge. Objectives: The objectives of this research are to 1) provide a more nuanced understanding of the ways in which socioeconomic context shapes gender role beliefs among low and middle SES African American adolescents and 2) examine how the construction of gender ideology and its subsequent relationship to sexual concurrency differs between African American and White adolescents. Methods: Qualitative data from semi-structured in-depth interviews with 32 African American adolescents in Baltimore, MD were analyzed to explore the role of socioeconomic instability in shaping adolescents’ beliefs about what it means to be a man or woman. Deductive and inductive approaches to qualitative analysis were adopted to identify recurring themes and concepts. Using quantitative household survey data, the validity and reliability of the Power and Attitudes in Relationships (PAIR) scale were tested within four distinct adolescent populations (N=352) in Baltimore, MD: African American males, White males, African American females, and White females. Mean scores by item were generated and PAIR’s association with having a risky partnership was tested using multivariate logistic regression within each subgroup. Using partnership-level data (N=462) from the same sample of African American and White adolescents, bivariate and multivariate logistic regression analyses were conducted to examine whether concurrency within heterosexual partnerships is associated with participants’ attitudes towards relationship power and to assess whether this relationship varies by race, SES, and/or type of partnership among adolescents in Baltimore, MD. Results Adolescents experienced interconnected vulnerabilities with periods of financial, housing, and family instability sometimes driven by family members’ use of drugs or incarceration. Their families often relied on social networks for support. Participants conceptualized gender roles in reaction to this insecurity. “Being a man” was to be financially stable, law-abiding, and a provider for family. “Being a woman” meant financial stability, maintaining a monogamous partnership, and limiting offspring. Transitioning into adulthood required youth to rise above adversity, relinquish social support, and take responsibility. PAIR may be a valid and reliable measure of relationship-oriented gender role beliefs among White and African American male and female adolescents. However, the factor structure and psychometric properties of the scale varied by sex and race. Overall, African Americans expressed more traditional attitudes towards power in relationships. Lower PAIR scores, indicating more traditional beliefs about heterosexual relationship power, were associated with having a high-risk sexual partnership among only two sub-samples (all males and White females). The opposite relationship was found in African American females. The practice of concurrency was common in our study sample, demonstrating its salience as a risk factor for STI transmission among adolescents in Baltimore. Results indicated that male adolescents who held more equitable attitudes towards the balance of power in sexual relationships were less likely to engage in index partner concurrency. Conversely, female adolescents who adhered to more equitable gender-related attitudes were more likely to experience sex partner concurrency. These relationships differed significantly by socioeconomic status among males and females and sexual partnership type among males. Conclusions The reduction of racial disparities in STIs requires that researchers and public health practitioners take a comprehensive approach to disease prevention that addresses the root causes of transmission. Gender role beliefs are a universal component of the human experience and may be a particularly salient predictor of sexual concurrency among African American adolescents. Understanding the nature of these beliefs and their nuanced relationship to sexual behavior is a first step towards improving sexual health outcomes for adolescents. | en_US |
| dc.format.mimetype | application/pdf | en_US |
| dc.identifier.uri | http://jhir.library.jhu.edu/handle/1774.2/36996 | |
| dc.language | en | |
| dc.publisher | Johns Hopkins University | |
| dc.subject | Gender Roles | en_US |
| dc.subject | Concurrency | en_US |
| dc.subject | Adolescents | en_US |
| dc.subject | African Americans | en_US |
| dc.title | Attitudes Towards Relationship Power and Concurrent Sexual Partnerships among African American Adolescents in Baltimore, MD | en_US |
| dc.type | Thesis | en_US |
| dc.type.material | text | en_US |
| local.embargo.lift | 2014-12-01 | en_US |
| local.embargo.terms | 2014-12-01 | en_US |
| thesis.degree.department | Health, Behavior and Society | en_US |
| thesis.degree.discipline | Public Health Studies | en_US |
| thesis.degree.grantor | Johns Hopkins University | en_US |
| thesis.degree.grantor | Bloomberg School of Public Health | en_US |
| thesis.degree.level | Doctoral | en_US |
| thesis.degree.name | Ph.D. | en_US |
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