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TP 4 The Relationship of Ethnicity, Class, and Gender Role Beliefs with STI Risk Behaviors Among Adolescents in Baltimore, Maryland

Tuesday, June 10, 2014
Pre-function Lobby (M2)
Susan Sherman, PhD, MPH, Epidemiology, John Hopkins Bloomberg School of Public Health, Baltimore, MD, Michelle Chung, MA, General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Baltimore, MD, Pamela Lilleston, PhD, MHS, Health, Behavior and Society, John Hopkins Bloomberg School of Public Health, Baltimore, MD, Jacky Jennings, PhD, MPH, General Pediatrics and Adolescent Medicine, Johns Hopkins School of Medicine, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD and Jonathan Ellen, MD, School of Medicine Ped Bay Bayview Pediatric Unit, The Johns Hopkins University, Baltimore, MD

Background:  Gender role beliefs are culturally-bound perceptions about how women and men should behave. Their influence on STI risk behaviors (i.e., concurrency) is established, but few studies have examined gender roles beliefs’ relationship to ethnicity and class as well as concurrency. The current study examines these relationships among a household sample of sexually active 15-24 year olds (N=352) in Baltimore, MD.

Methods:  Data were derived from a baseline assessment of a longitudinal study of gender norms (hypermasculinity and hyperfemininity) and STI risks among adolescents recruited from a stratified random household sample of African American and white adolescents who were low (primary guardian with no college) and middle (primary guardian with some college) SES. The hyperfemininity (among females) and hypermasculinity (among males) scales had alphas of 0.76 and 0.81, respectively. Weighted logistic regression models, stratified by gender, examined the relationships between SES/ethnicity, gender norms, and index concurrency.

Results:  The sample was 63% female, 70% African American, 57% were middle SES, and the median age was 21. Twenty-five percent reported index and 26% reported partner concurrency.   In adjusted (controlling for age) weighted regression models among males, a significant relationship was found between middle and lower SES African American with stricter gender role beliefs compared to middle SES whites [(β:2.18, 95%CIs: 0.81-3.54, β:2.87, 95%CIs: 1.41-4.33)]. Among females, a significant relationship was found between both lower SES white and middle SES African American with stricter gender role beliefs, compared to middle SES white [(β:2.11, 95%CIs: 0.37, 3.85), (β:1.68, 95%CIs: 0.24, 3.13)].  Among middle SES white females, stricter gender role beliefs were associated with concurrency (AOR: 1.47, 95%CIs: 1.14-1.89).  

Conclusions:  Our findings indicate complex relationships between ethnicity, SES, gender norms, and concurrency.  These intricacies suggest that both ethnicity and class influence gender role beliefs and sexual risk, indicating the importance of tailored interventions.

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