Using Narrative Health Messages to Motivate Reduction of Concurrent Partnerships Among Young African Americans

Theoretical Background and research questions/hypothesis:  Concurrent sexual partnerships may contribute to the continued HIV disparities within the African American community. Health messages delivered through narratives with culturally resonant language, characters and events may prompt proximal concurrency reduction behaviors, including discussion with partners, peers and providers. The aim of the present study was to examine the influence of message characteristics (i.e. messages that are perceived to be culturally resonant and engaging) on motivations to discuss safer sex behaviors. 

Methods and Results (informing the conceptual analysis): We surveyed African American students (n = 211) attending a large public university in the Southeast. As part of the survey, students listened to ads designed for radio broadcast to motivate less concurrency among young African Americans in Eastern North Carolina. Students rated the message characteristics (perceived cultural resonance and engagement with the messages) and motivations to discuss safer sex behaviors, as well as perceived norms and intentions to participate in concurrent sexual relationships. Participants also reported their relationship status, sexual activity and concurrency behavior in the past 12 months. The majority of participants were female (83%), and mean age was 22. Most participants (63%) reported sexual activity in the past 12 months and of these, 28% reported concurrency. Overall students had negative attitudes towards concurrency (M=2.33, SD =1.07) and perceived the behavior to not be the norm among their peers (M=2.35, SD=1.05). Students also strongly indicated that they would end relationships with a partner who had other partners (M=4.55, SD=.60). Consistent with prior research, males (M=2.92, SD=1.03) were more likely to perceive concurrent partnerships as normative than females (M=2.24, SD=1.02), t(189) =3.48, p<.01. Regarding reactions to the messages, participants perceived the messages to be culturally resonant (M=3.49, SD=.86) and engaging (M=3.46, SD=.77), and likely to motivate safer sex discussions (M =3.55, S =1.06). For example after hearing the ads, 65% of students said it is very likely that they would talk with their partner about concurrent sexual partnerships with a partner and 59% said they would talk with a friend. Further analyses revealed significant gender differences in perceptions of the messages and in motivations to discuss safer sex behaviors. Females were much more likely than males to report that the messages were culturally resonant (p<.05) and engaging (p=.06) that the messages would motivate them to discuss concurrency as well as to get tested (p<.001). 

Conclusions:  Despite negative attitudes and beliefs, some African American college students continue to have concurrent partners, suggesting the importance of college-based safer sex health communication interventions. The finding that participants expressed intentions and willingness to discuss concurrent sexual behaviors with their partners is encouraging. Culturally grounded health communication narratives may further motivate reduction of concurrent partnerships by prompting such discussions and thus reduce HIV disparities. 

Implications for research and/or practice: This study adds to further understansing of narrative persuasion and how to effectively design such messages.