142nd APHA Annual Meeting and Exposition

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Protective factors against fear of condom negotiation for African-American adolescents

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Jerrold M. Jackson, PhD , Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
Ralph J. DiClemente, PhD , Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory Univeristy, Atlanta, GA
Erikka J. Woolfolk , Emory University, Atlanta, GA
Background: Studies need to explore young African-American women’s condom negotiation relating to co-factors including self-efficacy and risky partner involvement.  Furthermore, there is insufficient literature on social support for condom negotiation in this population.

Methods: Demographic statistics and logistic regressions were completed on N=701 African-American women (mean age: 17.63), assessing baseline associations between refusal self-efficacy, condom self-efficacy, condom use, STI status, and fear of condom negotiation. Generalized estimating equations (GEE) assessed whether refusal self-efficacy, condom self-efficacy, condom use, and STI status were associated with fear of condom negotiation over time. Further analysis was conducted to determine protective factors against fear of condom negotiation. 

Results: Logistic regression (adjusting for age, intervention condition) examined baseline associations between fear of condom negotiation and refusal self-efficacy (AOR=0.84, 95% CI=0.8, 0.87), condom self-efficacy (AOR=1.04, 95% CI=1.02, 1.06), STI status (AOR=1.8, 95% CI=1.29,2.47), and unprotected sex (insignificant). A multivariate GEE examined fear of condom negotiation over time (adjusting for age and intervention condition). Two covariates demonstrated statistically significant effects across 36-months of follow-up: refusal self-efficacy (p<0.0001) and STI status (p=0.003). Condom self-efficacy and unprotected sex were not statistically significant predictors. Next, ‘social support’ was added to the GEE model and demonstrated significant effects (p=0.02), suggesting family and friends’ support and high levels of refusal self-efficacy may protect against fears of condom negotiation.

Conclusion: Refusal self-efficacy, social support and STI status influence fear of condom negotiation over time. Future studies should examine how individual, peer, and family influences may protect against fear of condom negotiation in this population.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Public health or related research
Social and behavioral sciences

Learning Objectives:
Identify risk factors and two key protective factors against fear of condom negotiation for African American adolescent females. Discuss the importance of future research identifying additional individual, peer, and family influences that may protect against fear of condom negotiation in this population.

Keyword(s): Risk Factors/Assesment, African American

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved in multiple federally funded grants focusing on STI, HIV, and drug use prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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