Sexual agency versus relational factors: a study of condom use antecedents among high-risk young African American womenRichard A. Crosby A B G , Ralph J. DiClemente C D E F , Gina M. Wingood C D , Laura F. Salazar C D , Sara Head A , Eve Rose C and Jessica McDermott-Sales C
A College of Public Health, University of Kentucky, 121 Washington Avenue, Lexington, KY 40506, USA.
B Rural Center for AIDS/STD Prevention, Indiana University, 801 East 7th Street, Bloomington, IN 47405, USA.
C Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University, 1516 Clifton Avenue, GA 30322, USA.
D Emory Center for AIDS Research, 1518 Clifton Avenue, Atlanta, GA 30322, USA.
E Emory University School of Medicine, Department of Pediatrics, Division of Infectious Diseases, Epidemiology, and Immunology, 2015 Uppergate Drive, Atlanta, GA 30322, USA.
F Emory University School of Medicine, Department of Medicine, Infectious Diseases, 1440 Clifton Avenue, Atlanta, GA 30322, USA.
G Corresponding author. Email: firstname.lastname@example.org
Sexual Health 5(1) 41-47 http://dx.doi.org/10.1071/SH07046
Submitted: 23 June 2007 Accepted: 30 October 2007 Published: 22 February 2008
Background: The influence that female partners exert regarding condom use is not well known. In the present study, the relative roles of personal sexual agency and relational factors in determining whether young African American women engaged in unprotected vaginal sex (UVS) were studied. Methods: A cross sectional study of 713 young, African American women (aged 15–21 years) was conducted. Data were collected using an audio-computer assisted self-interview. Three measures of sexual agency were assessed and three relational factors were assessed. To help assure validity in the outcome measure, condom use was assessed in five different ways. Multivariate analyses were used to determine whether variables independently predicted UVS. Results: Two of the six predictor variables achieved multivariate significance with all five measures of condom use: (1) fear of negotiating condom use with male partners, and (2) indicating that stopping to use condoms takes the fun out of sex. A relational factor (male-dominated power imbalances) achieved multivariate significance for four of the five measures of UVS. A sexual agency factor (whether young women greatly enjoyed sex) achieved multivariate significance for three of the five measures. Conclusion: The results suggest that young African American women at high-risk of sexually transmissible infections (STI)/HIV acquisition may experience male-dominated power imbalances and also fear the process of negotiating condom use with their male partners. Although these factors were independently associated with UVS, two factors pertaining to sexual agency of these young women were also important predictors of UVS. Intervention efforts designed to avert STI/HIV acquisition among young African American women should therefore include programs to address both sexual agency and relational factors.
Additional keywords: adolescent females, sexual behaviour, sexually transmissible infection.