Cultural Scripts Influencing HIV Prevention Among African American Women

A Ruth L. Kirschstein National Research Service Award (NRSA) for Individual Predoctoral Fellows (F31)

Recipient: Sarah Calabrese

Funded by the National Institute of Mental Health

Grant number: MH085584-01A1

African American women are profoundly and disproportionately affected by HIV/AIDS and other sexually transmitted epidemics. Despite comprising less than 14% of the female population in 2005 (U.S. Census Bureau, 2008) Black women represented approximately 64% of all U.S. women living with HIV/AIDS, the majority of whom contracted the HIV virus through heterosexual contact (CDC, 2008). In Washington, DC in particular, the disparity is even more striking: between 2001 and 2006, Black women accounted for 92% of all reported HIV cases among women (Government of the District of Colombia Department of Health, 2007). In light of these alarming statistics, an enhanced understanding of the impact of sociocultural factors specific to women of this ethnic group on their participation in unsafe sexual behavior is of utmost importance. Recent literature has emphasized the role of culturally transmitted guidelines and expectations about sexual behavior in perpetuating the epidemic among this population, suggesting that such specifications encourage unsafe sexual practices (Stephens & Phillips, 2003). However, the relationship of such expectations to African American women’s perceived capacity to assert themselves in enacting sexual safety (e.g., by enforcing condom use or refusing unwanted sex) is lacking empirical attention. The purpose of the proposed study is to address this gap in the literature by developing a measure of sexual expectations and examining the relationship of such expectations to sexual self-concept and sexual self-efficacy within a sample of HIV-positive and high-risk, HIV-negative African American women living in the Washington, DC metropolitan area. Researchers at The George Washington University will collaborate with the Women’s Interagency HIV Study (WIHS) to access the targeted population. A sample of approximately 191 African American women between the ages of 21 and 69, approximately three quarters of whom are HIV-positive, will be recruited from the existing WIHS sample. Participant interviews (n=8) and a focus group comprised of 8 women will inform instrument development, and quantitative measures will be administered to 175 women in paper-and-pencil, self-report format during regularly scheduled WIHS clinic visits.

PROJECT RELEVANCE: The proposed study is of public health importance in that it will clarify barriers to sexual safety among African American women, a vulnerable and underserved population at high risk for contracting and transmitting the HIV virus. Findings will be useful in informing the development of culturally appropriate intervention programs targeting this group, ultimately aiding the effort to combat the HIV/AIDS epidemic within and beyond the African American community.