A systematic review of observational and experimental literature: Risk factors described by the Theory of Gender and Power tested as correlates of condom use among African American female adolescents

Introduction: The Theory of Gender and Power (TGP) provides a framework for understanding HIV risk among women (sexual division of labor, sexual division of power and affective attachments and social norms) and has guided construct selection for observational and experimental research. The purpose of this review was to synthesize 10-years of empirical research on HIV risk factors as presented in the TGP framework and their association with condom use. Study goals included: 1) exploring sources of heterogeneity in study findings and 2) the relation of these factors to one another in the context of condom use.

Methods: A systematic review was conducted of articles that were in English, peer-reviewed, published between 1998-2008 and tested the association between a TGP-defined risk factor (e. g. sexual communication self efficacy, depression, familial support, abuse experiences) and condom use among African American female adolescents.

Results: Preliminary results suggest variability in the manner in which TGP risk factors are defined and measured as well as in the assessment of condom use. Studies that incorporate multiple measures of condom use appear to be more rigorous. Finally, interrelationships between theory constructs exist, and these reveal the potential for the TGP to include meditational pathways of risk.

Conclusion: The TGP framework is uniquely suited to exploring risky sexual behavior among African American female adolescents as it acknowledges the importance of power and that condom use is a negotiated behavior. Consistency in measurement and continued exploration of mediation can further enhance the understanding of mechanisms of risk.