Silences, Gestures, and Words: Nonverbal and Verbal Communication About HIV/AIDS and Condom Use in Black Heterosexual Relationships (original) (raw)
Related papers
Reactions of Heterosexual African American Men to Women's Condom Negotiation Strategies
Journal of Sex Research, 2010
This study describes responses of 172 single heterosexual African American men, ages 18-35, to condom negotiation attempts. Strategies used included reward, coercive, legitimate, expert, referent, and informational strategies, based on Raven's (1992) influence model. The purpose was: 1) to identify strategies influencing participant acquiescence to request, and 2) to identify predictors of participant compliance/refusal to comply with negotiation attempts. Participants viewed six videotape segments showing an actress, portrayed in silhouette, speaking to the viewer as a 'steady partner'. After each segment, participants completed measures of: request compliance, positive and negative affect, and attributions concerning the model and themselves. No significant differences were found in men's ratings across all vignettes. However, differences in response existed across subgroups of individuals, suggesting that while the strategy used had little impact on participant response, the act of suggesting condom use produced responses that differed across participant subgroups. Subgroups differed on levels of AIDS risk knowledge, STD history, and experience with sexual coercion. Also, the "least-willing-to-use" subgroup was highest in anger/rejection and least likely to make attributions of caring for partner. Effective negotiation of condom use with a male sexual partner may not be determined as much by specific strategy used as by partner characteristics.
HIV-Related Communication and Safe Sex Practices among Heterosexual Black Men: A Qualitative Report
Journal of Black Sexuality and Relationships, 2018
HIV prevention efforts have given limited attention to the influence of social norms on the process of communicating about safer sex practices among heterosexual Black men. To address this and inform the development of an HIV prevention behavioral intervention for heterosexual African American men, we conducted computerized, structured interviews with 61 men living in high HIV prevalence neighborhoods in New York City to participate in either one of the five focus group interviews and/or an in-depth qualitative interview. Participants had a mean age of 33 years, 25% held less than a high school education, 66% earned an annual income of $10,000 or less, and 86% had a history of incarceration Qualitative analysis was used to identify emergent themes within the domains of condom use communication, HIV status disclosure with sexual partners, and general
AIDS Patient Care and STDs, 2017
Conversations about HIV prevention before engaging in sex may result in safer sex practices and decreased HIV transmission. However, partner communication for HIV prevention has been understudied among black/African American men who have sex with men (BMSM), a group that is disproportionately affected by HIV. We explored and described encounters and perceptions about HIV prevention conversations among BMSM and their sex partner(s) in New York City. We conducted an inductive thematic analysis of semi-structured interviews with BMSM who reported sex with a man in the previous 3 months. Interviews were professionally transcribed; Nvivo was used for data analysis. Twenty-two BMSM were included in this analysis; median age = 29.1 years; 71.4% self-identified as MSM; 85.7% were ever HIV tested; and 52.6% reported no disclosure or discussion about HIV status with their previous sex partner. The main themes were: (1) missed opportunities for HIV prevention conversations (e.g., no HIV prevention conversations or HIV prevention conversations after sex had occurred); (2) barriers to HIV prevention conversations (e.g., being in the moment; not wanting to pause); (3) emotional thoughts after sex (e.g., feeling worried about possible HIV exposure); and (4) rethinking relationships and sexual health (e.g., changed sex practices by asking partners' HIV status before sex; started using condoms). These findings offer insight into HIV prevention conversations by BMSM around the time of or during sexual encounters and may inform and strengthen partner-level HIV prevention communication interventions for BMSM.
Journal of Health Communication, 2016
The present research extends the Theory of Planned Behavior (TPB) to investigate how communication-related variables influence condom use intention and behavior among African American women. According to the TPB, attitudes, subjective norms, and self-efficacy are associated with behavioral intent, which predicts behavior. For women, it was argued that condom negotiation self-efficacy was more important than condom use self-efficacy in predicting consistent condom use. Moreover, an important environmental factor that affects condom use for African American women is fear or worry when negotiating condom use because the sex partners might leave, threaten, or abuse them. Fears associated with negotiating condom use were predicted to be negatively associated with attitudes, subjective norms, and self-efficacy. African American women (N = 560; M age = 20.58) completed assessments of TPB variables at baseline and condom use three months later. Condom negotiation self-efficacy was a significant indicator of behavioral intent while condom use self-efficacy was not. Fear of condom negotiation was negatively associated with all TPB components, which was in turn significantly associated with behavioral intent and condom use. Implications for the TPB, safer sex literature, and STI prevention intervention design are discussed. African American women continue to be disproportionately affected by sexually transmitted diseases. In the US, the most recent updates from the Centers for Disease Control and Prevention (CDC, 2015) reported that the proportion of African American women with HIV infections was 20 times that of white women and almost five times that of Hispanic/Latina women. Similarly, the rate of reported case of chlamydia, gonorrhea, and syphilis among African American women were 5.8, 12, and 15 times the rate among white women respectively (CDC, 2013). Notably, one of the risky activities that are associated with both HIV and STIs is having sex without a condom, and one of the effective approaches for HIV and STI prevention is to use condoms consistently and correctly (CDC, 2014). Several prevention interventions have been developed to counteract the relatively higher STI/HIV rates among African American women (e.g.,
Psychology of Women Quarterly, 2004
This qualitative study explored the association between African American women's interpersonal relationship and sexual scripts and condom use with primary partners. Participants were 14 lower to middle-income women between the ages of 22 and 39 involved in emotionally and sexually intimate heterosexual relationships. Relationship types included those that were: stable, emotionally committed; casual, primarily sexual; and unstable, emotionally imbalanced and/or conflict-ridden. Respondents completed a semi-structured interview and a questionnaire about their relationships, sexual, and condom use behaviors. Data analyses identified 3 interpersonal relationship scripts (i.e., men control relationships, women sustain relationships, infidelity is normative) and 2 interpersonal sexual scripts (i.e., men control sexual activity; women want to use condoms, but men control condom use) that may indirectly or directly decrease African American women's condom use with primary partners, ...
Understanding barriers to condom usage among HIV-infected African American women
Journal of the Association of Nurses in AIDS Care, 1998
Drawing on focus group discussions with adolescent and adult HIV-infected women between the ages of 16 and 45, this study explores the barriers to condom use among women infected with HIE. Although most of the participants were comfortable discussing condoms and sexuality, there was little, if any, negotiation of condom use with their male partners. Most of the participants used condoms inconsistently or not at all. Reasons for nonuse included a lack of trust in the reliability of condoms to protect them, a lack of desire for pregnancy prevention, and the male partner's refusal to use condoms. Women in discordant relationships explained their uninfected partner's refusal to use condoms as denial of the risk of contracting HIV or as a way of expressing their love for the infected partner. Women also had great difficulty in disclosing their HIV status to both family and partners. Prevention efforts to increase condom use among HIV-infected women should target both men and women and focus on negotiation and communication skills.
This pilot study examined effects of HIV prevention messages about self and partner benefits of antiretroviral therapy (ART) and condom effectiveness on increased intentions for behavior change. Data were from Messages4Men, a study examining prevention messages among 320 HIV-positive and 605 HIV-negative Black and Latino MSM. Men completed a computer-based assessment after message exposure, and multivariable models controlled for risky sex and demographics. A majority of HIV-positive men reported increased intentions for ART use; 22% reported partner benefit information was new. HIV-positive men with a detectable viral load had significantly greater adjusted odds of reporting intentions for ART use. Over half of HIV-negative MSM reported ART benefit information was new, and 88% reported increased intentions to discuss ART use with infected partners. Black MSM anticipated they would increase condom use in response to the self and partner benefit messages. Tailored messages on benefits of ART are needed for MSM.
Journal of Racial and Ethnic Health Disparities
African American women are 10.8 times more likely to be diagnosed with HIV compared with White women. This descriptive study fills a gap by examining associations among social and contextual factors and sexual communication, condom use, and safer sex negotiation among African American women. Study participants between 18 and 25 years of age and who reported recent substance use were recruited from three North Carolina counties. A risk behavior survey was administered via audio computer-assisted self-interview, and logistic regression analyses were conducted to assess associations between social and contextual variables and condom use at last sex with a main partner. Education (AOR: 2.078; 95% CI: 1.214, 3.556), sexual communication with a main partner (AOR: 1.079; 95% CI: 1.050, 1.109), and condom use relationship scale (AOR: 1.059; 95% CI: 1.023, 1.098) were positively associated with condom use at last sex, whereas living with a main partner (AOR: 0.447; 95% CI: 0.210, 0.950) and ...
Condom negotiation among young Black men who have sex with men in the Southern United States was explored using the theory of reasoned action. Fifty-four (18- to 29- year- old) males participated in nine focus group interviews. Discussions elicited condom use and negotiation attitudes, beliefs and social norms. Positive personal attitudes (respect of self, personal health concerns) and high negotiation self- efficacy was emphasized. Conversely, social norms revealed nonprioritized condom use behavior. Divergence between individual and community indicates theoretical models targeting sexual communication must address external factors (social, economic, political context), which intersects with individual intentions, attitudes to influence HIV prevalence in this community.
Journal of Sex Research, 2008
Little research has been performed on how people respond to different strategies to negotiate condom use in sexual situations, and whether certain strategies tend to be perceived as more or less effective in condom use negotiation. This study examined gender differences and preferences in the use of and response to six different styles of condom use negotiation with a hypothetical sexual partner of the opposite gender. Participants were 51 heterosexually-active African-American men and women between the ages of 18 and 35, attending an inner-city community center. Study participants completed a semi-structured qualitative interview in which they were presented with six negotiation strategies -coercive, reward, legitimate, expert, referent, and informational--based on Raven's 1992 Power/Interaction Model of Interpersonal Influence. Results showed that women participants responded best to referent, reward, and legitimate strategies, and worst to informational tactics. Men participants responded best to reward strategies, and worst to coercion to use condoms. Further, responses given by a subset of both women-and, to a greater extent, men--indicated that use of negotiation tactics involving coercion to use condoms may result in negative or angry reactions. Finally, response to strategies may vary with the value of the relationship as viewed by the target of negotiation. Implications for HIV prevention programs and media campaigns are discussed.