“…Based on the literature on IPA risk factors among mainstream lesbian and heterosexual African Americans, it is likely that the most critical risk factors associated with IPA among African American lesbians would include: (a) poverty or low economic status (Balsam et al 2010;Lockhart et al 1994;McKenry et al 2006;Powell 2008;Williams et al 2008a, b), which includes insufficient access to educational and employment opportunities; (b) childhood victimization (Balsam 2001(Balsam , 2003Coleman 2003;McKenry et al 2006;Powell 2008;Williams et al 2008a, b), which includes physical, sexual, and vicarious abuse such as witnessing community or family violence, or neglect; (c) mental health symptoms (Balsam 2001(Balsam , 2003Coleman 2003;Liesring et al 2003;Lockhart et al 1994;McKenry et al 2006;Miller et al 2001;Poorman and Seelau 2001), which includes disordered or overly enmeshed attachment, disordered personality organization, PTSD, anxiety, and depression; and (d) substance abuse (Coleman 2003;Goldenson et al 2009;Lockhart et al 1994;McKenry et al 2006;Powell 2008;Stevens et al 2010;Williams et al 2008a, b), which may include alcohol or drugs. Other factors that would exacerbate IPA among African American lesbians might include desires for power and control, which could be a reaction to experiences of powerlessness in daily life resulting from the intersecting impacts of institutionalized or internalized sexism, racism, and heterosexism (Balsam 2001(Balsam , 2003Hardesty et al 2008;McKenry et al 2006;Tigert 2001).…”