Understanding African Americans' Perceptions of Sexual Health: Findings from an Online National Survey and Implications for Health Communication Interventions

Background:  Communication interventions have the potential to promote safer-sex behaviors; reduce STD-associated stigma; and confront the glaring racial disparities in the United States. Reframing STD messaging into a broader sexual health context may help achieve these goals, if understandable, acceptable and relevant to affected communities. This research sought to explore African American’s understandings of sexual health and perceived sexual-health information needs.

Methods: A national online survey was conducted with 551 African Americans using a nonprobability-based quota sample of eligible individuals. Survey items assessed sexual health definitions (open-ended, qualitative response), perceived importance of 15 predetermined sexual health items, and communication preferences (STD or sexual health messages). Frequencies, means, and standard deviations were calculated for quantitative responses. Qualitative data was analyzed by two researchers using a grounded theory approach.

Results: Among the 535 qualitative responses received, sexual health was most often defined as protection of the physical body, including safe sex, having/not having an STD, or physical health/well-being. Fewer responses mentioned partner communication, testing/treatment, being faithful, or choosing celibacy. Regarding the close-ended responses, most said that HIV testing (90%), STD testing (89%), condom use (89%), thoughtful sexual decisions (86%), avoiding abusive relationships (85%) and partner/provider communication (85%) were very important for staying in good sexual health. Over 80% felt their communities would benefit from information about STDs (86%), HIV (85%), taking responsibility for prevention (87%), partner communication (87%) and respect (87%), getting tested (88%), using condoms (89%), and avoiding unplanned pregnancies (83%). Significant differences emerged by segment.  A majority (60%) said they would be more interested in reading about sexual health than STDs.

Conclusions: Findings suggest variations in conceptualizations of sexual health, which may provide an opportunity for prevention efforts. Most respondents agreed that their communities would benefit from sexual health information and preferred a sexual-health (to STD) framing.