Experiences of Racial Discrimination Among African-American Women: Is It Associated with Risky Sexual Behavior and Psychosocial Mediators of HIV/STI-Associated Sexual Risk Behavior?

Background: Previous research has established that racial disparities exist regarding HIV/STI diagnoses.  African-American women are disproportionately represented among HIV/STI diagnoses in the United States, especially in the South.  Therefore, it is pertinent to examine factors associated with increased risky sexual behaviors to have a better understanding of the disparities in this population.

Objectives: To examine the associations between experiences of racial discrimination and risky sexual behavior and psychosocial mediators of HIV/STI-risk behaviors among young adult African-American women.

Methods: Eight hundred forty-eight African-American women, 18-29 years, participated in the study at baseline.  Data collection occurred from October 2002 through March 2006.  Participants completed a 40-minute Audio Computer Assisted Survey Interview (ACASI) assessing sociodemographics, experiences with racial discrimination via The Schedule of Racist Events, multiple sexual partners, risky/abusive partners, partner-related risky sexual behaviors, sexual communication frequency, and condom barriers.

Results: Multiple logistic regression analyses, with age and socioeconomic status as covariates, indicated that participants reporting higher levels of racial discrimination were more likely to report multiple sexual partners over the past 12 months (AOR= 1.49, p= .005) and over the past 6 months (AOR= 1.54, p= .003), having an abusive partner (AOR= 1.69, p= .002), having a risky or abusive partner (AOR= 1.38, p= .02), lower partner sexual communication frequency (AOR= 1.57, p= .001), higher partner-related (AOR= 1.46, p= .008), mood-related (AOR= 1.50, p= .004), and oral sex-related condom barriers (AOR= 1.67, p= .0001).

Conclusions: Experiences of racial discrimination were associated with partner-related risk behaviors, condom use barriers, and lower sexual communication frequency.

Implications for Programs, Policy, and/or Research: Results from this study indicate the importance of expanding beyond individual-level interventions.  Community and family-level interventions that address discrimination and promote racial/ethnic pride may be an effective strategy of reducing HIV/STI-risk behavior among young adult African-American women.