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“And Let Me See Them Damn Papers!” The Role of STI/AIDS Screening Among Urban African American and Puerto Rican Youth in the Transition to Sex Without a Condom

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Abstract

Common strategies employed in preventing STI/AIDS transmission among young adults in America include abstinence, monogamy and safer sex. These strategies require a high level of vigilance and responsibility and, according to inner city participants in Project PHRESH.comm, neither option is always desirable, available, or rational in the context of their lived experiences. This article reports findings from Project PHRESH.comm, a mixed-method, ethnographic study incorporating data from focus group discussions, semi-structured interviews, coital diaries, systematic cultural assessments and a structured survey designed to explore concepts of risk and decision making about condom use among at risk African American and Puerto Rican young adults aged 18–25 years in Hartford, CT. We found that many young adults from our study population rely on a strategy of using clinic-sponsored STI/AIDS screening when wanting to discontinue condom use with a partner. While our data suggest that screening is a common strategy used by many couples to transition to having sex without a condom, the data also show that most youth do not maintain monogamy even in long-term, serious relationships. Thus, sharing test results may provide a false sense of security in the sexual culture of inner city, minority youth.

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Notes

  1. This research was supported by Award Numbers U58/CCU123064 and U58/CCU323065 from the CDC. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC or the Family Planning Council of Philadelphia.

  2. Participants were eligible if they met the universal eligibility criteria: age 18–25, had had sex with a member of the opposite sex in the last year, born in the United States or Puerto Rico, self-identified as African American or Puerto Rican, and spoke English (FGD, SCA, SI methods) or English or Spanish (SRI and CD methods—Hartford only). The language criteria were imposed for practical reasons to maintain consistency between the Hartford and Philadelphia sites. All Spanish interviews were translated into English. There were two SRIs and three CDs completed in Spanish; most Puerto Ricans in this age group spoke English. The CD method had more stringent eligibility criteria—having had sex at least three times in the last 30 days with a member of the opposite sex and having had sex with more than one person in the last 30 days. An additional eligibility criterion for SI participants was not having participated in any of the other PHRESH methods.

  3. For our participants, the “lifetime” in question was 18–25 years.

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Acknowledgments

The authors would like to acknowledge the many people who contributed to this article. Drs. Pamela Erickson and Merrill Singer were the senior scientists on the project. Rosemary Diaz, Anna Marie Nicolaysen, Dugeidy Ortiz and Traci Abraham worked as ethnographic interviewers and were responsible for collecting the data used herein. Traci Abraham drafted the manuscript and was responsible for data interpretation. Mark Macauda provided the quantitative data analysis used in triangulating the qualitative findings as well as quantitative analysis of demographic data. All co-authors, along with Linda Hock-Long, PI from the Philadelphia site, and Marion Carter, Kendra Hatfield-Timajchy and Joan Kraft, all from the CDC, reviewed consecutive drafts of the manuscript and provided critical feedback on its structure and content. This research was supported by Award Numbers U58/CCU123064 and U58/CCU323065 from the Centers for Disease Control and Prevention (CDC), Division of Reproductive Health.

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Authors and Affiliations

  1. The University of Connecticut, Storrs, CT, USA

    Traci Abraham, Pamela Erickson & Merrill Singer

  2. The University of South Carolina, Columbia, SC, USA

    Mark Macauda

  3. Calle Betis 50, Atico Izq, 41010, Sevilla, Spain

    Traci Abraham

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  1. Traci Abraham
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Correspondence to Traci Abraham.

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Abraham, T., Macauda, M., Erickson, P. et al. “And Let Me See Them Damn Papers!” The Role of STI/AIDS Screening Among Urban African American and Puerto Rican Youth in the Transition to Sex Without a Condom. AIDS Behav 15, 1359–1371 (2011). https://doi.org/10.1007/s10461-010-9811-z

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