Multiple dimensions of sexual safety: Perspectives from Black emerging adult women

Background: Sexually transmitted infections, unintended pregnancies, and HIV/AIDS among Black emerging adult women (BEAW), 18 – 25 years old, are increasing. Sexual safety is narrowly conceptualized as risk behavior avoidance. Risk-based frameworks provide a unidimensional understanding of sexual phenomena and health consequences. Little is known about varied ways women manage sexual safety while meeting healthy sexuality needs. Healthy sexuality in this research attends to emotional love, trust, intimacy, and desire. Merging these concepts with current frameworks provides greater visibility for BEAW's sexual health needs.

Methods: We recruited 25 BEAW from beauty salons and conducted in-depth interviews to elicit stories about sexuality and sexual safety in relationships. Field notes, memos, and interview transcripts were managed using nVivo9. We performed thematic and structural narrative analyses to illuminate content-driven conclusions. Results: Emotional safety emerged as a foundational narrative underpinning participants' sexual relationships. Safety was mediated a desire for personal agency. They navigated relational tensions that facilitated or hindered control of physical and emotional outcomes. Actions of engaging in or being affected by symbolic violence, caring for the self, and developing a personal identity shaped approaches to sexual safety. Notably, physical safety was often overshadowed by emotional safety and personal agency.

Discussion: Participants' in-depth descriptions of emotional safety reflect new understandings about behavioral complexities within sexual relationships for BEAW. Understanding personal agency and emotional safety in contrast to physical safety and risks of sexual behavior consequences offers novel direction for designing effective intervention studies, evidence-based practices, and policy to promote sexual health among BEAW.