Sex Partner Type, Drug Use and Condom Use Self-Efficacy Among African Americans from Disadvantaged Neighborhoods: Are Associations with Consistent Condom Use Moderated by Gender?

Abstract

Gender inequalities in sexual behavior are explored from the perspective of the theory of gender and power. This study focused on the effect of sex partner type (steady versus casual), drug use, and condom use self-efficacy regarding consistent condom use (CCU) among a community-based sample of adults. The sample included 1,357 African American men and women (M age 37.0, SD 13.1 years; 44% women, 66% men) from 61 disadvantaged census block groups in Atlanta, GA as part of a study of individual and neighborhood characteristics and HIV risk-taking. Having a steady partner decreased the odds of CCU, while higher condom use self-efficacy increased the odds of CCU. Among non-drug users, having a drug-using partner was associated with decreased odds of condom use for women only. Women with drug-using partners, especially a steady partner, were least likely to report CCU. Therefore, interventions intended to empower CCU among women need to expand beyond acknowledging the reduced control that women who use drugs demonstrate to also consider those who have drug-using sexual partners.

Factors Associated with African American Women’s Sexual Health and Risk Behavior: A Mixed Methods Study

“…Researchers suggest that AAW who have steady sexual partners have decreased odds of consistently using condoms (Nehl et al, 2015). Additionally, having a drug using sexual partner also decreased the odds of consistent condom use for AAW (Nehl et al, 2015). These results indicate that relational factors involving women's relationships or type of sexual partner may influence participation in risky sexual behavior and increase AAW's risk of acquiring STIs or experiencing unintended pregnancy.…”

“…Nehl and colleagues (2015) reveal that the composition of AAW's sexual relationships and the determination of whether sexual partners were steady or casual moderated women's consistent condom use. Researchers suggest that AAW who have steady sexual partners have decreased odds of consistently using condoms (Nehl et al, 2015). Additionally, having a drug using sexual partner also decreased the odds of consistent condom use for AAW (Nehl et al, 2015).…”

“…In a qualitative study conducted by McLellan-Lemal et al (2013), challenges created by relationship power caused discord within relationships that could lead to sexual violence. Other studies indicate that imbalances in power increased women's sexual risk from being coerced into participation in behaviors including drug use and concurrent sexual partnerships (McLellan-Lemal et al, 2012;Nehl et al, 2015).…”

“…The two remaining studies included in this review explore gender inequalities related to the negotiation of power within relationships and their influence on women's sexual behavior (McLellan-Lemal et al, 2013;Nehl et al, 2015). In a qualitative study conducted by McLellan-Lemal et al (2013), researchers explored AAW's perceptions regarding relationships, relationship power, and their ability to make decisions.…”

“…Recently, the influence of power and gender within women's relationships has been recognized as a factor influencing negative health outcomes and sexual health disparities in AAW (Blanc, 2001). This review includes four research studies investigating the influence of gender inequality on AAW's sexual risk and behavior (McLellan-Lemal et al, 2013;Nehl et al, 2015).…”