Out of Control: Factors associated with perceived relationship control among African-American adolescent girls

INTRODUCTION: The theory of gender and power emphasizes power imbalances in sexual relationships, in which African-American women have less control than their male partners, may place women at increased risk for STD/HIV acquisition. This study explores factors related to woman's perceived of control in sexual partnerships.

METHODS: 701 African-American adolescent females aged 14-20 years completed an ACASI as part of an STD/HIV prevention program. Demographics, abuse history, condom use, STD history, sexual behaviors, information about male sexual partners and relationships, and perceived control in relationship were assessed at baseline, prior to participation in the intervention.

RESULTS: Contingency table analyses observed that adolescents with lower perceived relationship control were significantly less satisfied in their relationship (p=.001), less likely to use condoms at last sex (p=.011), more likely to have a prior STD (p=.017), and more likely to perceive that their male partner has concurrent relationships (p=.001). Multivariate results indicate that male partner concurrency (AOR 2.42, p=.001), relationship satisfaction (AOR=2.31, p=.001), and condom use at last sex (AOR=0.69, p=.052) remain significantly associated with adolescents having less perceived relationship control.

CONCLUSION: Adolescent females with less control in sexual relationships had markedly higher risk behaviors. Risk-reduction interventions should offer tools for increasing adolescents' sense of control in relationship, as well as selecting male partners who support egalitarian relationships where power is balanced. HIV/STD risk-reduction interventions with females and males should encourage relationships where power is balanced and assist with resources in unhealthy relationships.