Impact of Attitudes and Beliefs Regarding African American Sexual Behavior on STD Prevention and Control in African American Communities: Unintended Consequences

Abstract

Compared to whites, blacks experience significant health disparities for sexually transmitted diseases, particularly in the rates of chlamydia, gonorrhea, and syphilis. To develop more effective interventions to control and prevent STDs, public health practitioners should better understand and respond to factors that facilitate sexual risk-taking behaviors and impede access to STD health care and make use of factors that promote sexual health. Legacies of slavery, racism, and economic or class discrimination leave many blacks suspicious of interventions aimed at improving the welfare of their communities. Sexual behavior, in particular, has been used to justify social oppression of blacks in the United States. Although efforts to engage affected black communities in improving STD health care delivery have been undertaken, bias, prejudice, and stereotyping continue to contribute to negative experiences for many blacks across health care settings, including those involving STD care. Implementing more effective interventions to reduce the disparate burden of bacterial STDs in black communities requires accessible and acceptable STD health care. Understanding and addressing the potential impact of both provider and patient attitudes can improve these service delivery outcomes.

Developmental Patterns of Adolescent Marijuana and Alcohol Use and Their Joint Association with Sexual Risk Behavior and Outcomes in Young Adulthood

“…Among urban youth, teenage pregnancy is more normative due to its higher rates [28]. These negative outcomes are further compounded in metropolitan areas by elevated rates of poverty, incarceration, dense sexual networks, discrimination, racial segregation, and lack of health insurance and regular sources of care [1,9,22,50].…”

“…They suffer from high rates of HIV/AIDS and other sexually transmitted infections (STIs) and disproportionately experience teenage pregnancies [5,39,50]. The morbidity and mortality associated with early parenting and STIs contribute greatly to racial disparities in health [10,16,17,39].…”

Racial Isolation and Chlamydia Rates in US Counties

“…In addition, sex ratio imbalances are related to STDs (Adimora et al 2009;Adimora and Schoenbach 2005) because sex ratio imbalances encourage women to tolerate concurrent partnerships when they feel there are few options (Aral 1996;Valentine 2008). These concurrent partnerships can increase the risk of spreading infections more rapidly within the community (Adimora and Schoenbach 2005).…”

An early warning sign: sexually transmissible infections among young African American women and the need for preemptive, combination HIV prevention

“…15,17 Furthermore, sexual health screenings for both male and female youth can be encouraged, so screenings become a normal part of healthy sexuality rather than stigmatising and shameful. 18 There is also an opportunity for public health to reverse the breaches of trust in African American communities 19,20 and for youth around sexual health services. This will require that African American youth and their families have access to respectful, ethical, quality sexual health services.…”

“…This will require that African American youth and their families have access to respectful, ethical, quality sexual health services. 18 Third, there is a movement in HIV prevention to address the social determinants of sexual risk. 21,22 For young African American women and their partners, the gender, racial and often economic disadvantage frame, in part, the social context for heterosexual behaviours.…”