Adolescent girls' perspectives on partner abuse and safe sex: Identifying barriers and suggestions for strengthening HIV prevention programs

Adolescent girls are at high risk for sexually transmitted infections (STIs), including HIV, and African-American girls are disproportionately affected. Prior research indicates partner abuse can be a barrier to safer sex practices. In order to develop appropriate interventions, this study used focus groups to understand how partner abuse influences safer sex practices from the perspective of African American adolescent females.

African-American girls (ages 14-17) were recruited from family planning and prenatal clinics in a large urban area in the US. Forty – six girls completed a brief survey and were invited to participate in one of four focus groups. Content analysis was used to examine focus group transcripts.

Twenty-seven girls had experienced abuse (either physical or verbal or both). Participants identified a sexual double standard that rewarded young men and stigmatized young women for having multiple partners, but many challenged this norm. Girls who did not follow this norm could face physical abuse by a partner. Girls thought those in abusive relationships were less likely to use condoms due to forced sex, physical abuse, fear a partner might leave or hit her, partner control and condom sabotage. Unwanted unprotected sex was seen as a form of abuse. Most indicated it was not possible to practice safer sex in an abusive relationship. Girls suggested programs should include males with both gender-specific and combined sessions and offer HIV/STI testing.

HIV/STI prevention programs for African-American adolescent females can be strengthened by addressing gender norms, providing information about partner abuse, including testing, and involving males.