Contextual Factors and Sexual Risk Behaviors among Young, African-American Men. What's Really Explaining Sexual Risk for this Group?

Objective: To determine associations between contextual factors and sexually risky behaviors among a sample of young Black males attending adolescent health clinics.

Methods: Baseline data from a larger, randomized controlled trial were used for this study. Data were collected in three adolescent health clinics in New Orleans, LA, Baton Rouge, LA and Charlotte, NC. Males, who identified as Black/African American, 15-23 years of age, were eligible. Seven-hundred and two participants were enrolled and completed a baseline survey. Sexual risk behaviors were the frequency of unprotected vaginal sex (UVS) in the past 2 months, number of sexual partners within last two months and number of lifetime sexual partners. Parental monitoring, risky environmental context, desire to impregnate a woman, and peer norms supportive of unsafe sex were potential contextual variables that could explain sexual risk behaviors.

Results: Median number of sexual partners in the previous two months and lifetime was 2 and 11, respectively. Over half the sample (61.2%) reported UVS at least once. In adjusted negative binomial regression analyses, neither parental monitoring nor pregnancy desire was significant. Risky environmental context was associated with sexual partners in previous two months (p<0.001), lifetime sexual partners (p=0.038) and UVS (p=0.001). Peer norms were associated with sexual partners in previous two months (p=0.032), lifetime sexual partners (p=0.008) and UVS (p<0.001).

Conclusion: Among, young African American males, parental monitoring and desire to impregnate a woman have less influence on sexual risk than environmental context and peers. Interventions should consider these contextual influences when designing preventive interventions.