Skip to main content

Advertisement

SpringerLink
Log in

Socio-ecologic Correlates of HIV/AIDS-Related Sexual Risk Behavior of African American Emerging Adults

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

There is growing evidence showing that patterns of individual sexual risk behaviors are insufficient in explaining the disproportionate HIV/AIDS burden borne by African Americans. Instead, dynamic features of social, economic, political, and geographic contexts play a more determining role. However, not enough studies have examined the impact of multi-level factors including neighborhood-level influences on HIV/AIDS sexual risk among African American emerging adults using a socio-ecologic perspective. Anchored on the socio-ecologic framework, this study examines the collective role of relevant socio-ecologic determinants of sexual risk-taking among African American emerging adults. Results from both bivariate and multivariate analyses revealed that individual and neighborhood-level variables were significantly associated with sexual risk in our study population partially confirming the hypothesis of the study. Male gender, educational attainment, and neighborhood social disorder were the strongest predictors of sexual risk. Our findings contribute to the vast literature on sexual risk behavior patterns of young adults, and increasing evidence demonstrating the role of contextual factors as stronger predictors of sexual risk and HIV infection among at-risk youth. Our findings, however, underscore the need for further research on the pathways of HIV socio-behavioral vulnerability in this demographic group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Tillerson K. Explaining racial disparities in HIV/AIDS incidence among women in the U.S.: a systematic review. Stat Med. 2008;27(20):4132–43. https://doi.org/10.1002/sim.3224.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Levy ME, Wilton L, Phillips G 2nd, et al. Understanding structural barriers to accessing HIV testing and prevention services among Black men who have sex with men (BMSM) in the United States. AIDS Behav. 2014;18(5):972–96. https://doi.org/10.1007/s10461-014-0719-x.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Magnus M, Kuo I, Phillips G, et al. Elevated HIV prevalence despite lower rates of sexual risk behaviors among Black men in the district of Columbia who have sex with men. AIDS Patient Care STDS. 2010;24(10):615–22. https://doi.org/10.1089/apc.2010.0111.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Ross MW, Henry D, Freeman A, Caughy M, Dawson AG Jr. Environmental influences on safer sex in young gay men: a situational presentation approach to measuring influences on sexual health. Arch Sex Behav. 2004;33(3):249–57. https://doi.org/10.1023/B:ASEB.0000026624.69223.5f.

    Article  PubMed  Google Scholar 

  5. Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Soc Sci Med. 2005;61(5):1026–44. https://doi.org/10.1016/j.socscimed.2004.12.024.

    Article  PubMed  Google Scholar 

  6. Marshall BDL, Kerr T, Shoveller JA, Montaner JSG, Wood E. Structural factors associated with an increased risk of HIV and sexually transmitted infection transmission among street-involved youth. BMC Public Health. 2009;9(1):7. https://doi.org/10.1186/1471-2458-9-7.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bronfenbrenner U. The ecology of human development: experiments by nature and design. London: Harvard University Press; 2009. https://doi.org/10.2307/j.ctv26071r6.

    Book  Google Scholar 

  8. Dyer T, Latkin C, Linton S, Rudolph A. Individual, network, and neighborhood correlates of exchange sex among female non-injection drug users in Baltimore. MD AIDS Behav. 2013;17(2):598–611.

    Article  PubMed  Google Scholar 

  9. Poundstone KE, Strathdee SA, Celentano DD. The social epidemiology of human immunodeficiency virus/acquired immunodeficiency syndrome. Epidemiol Rev. 2004;26(1):22–35. https://doi.org/10.1093/epirev/mxh005.

    Article  CAS  PubMed  Google Scholar 

  10. Inanc H, Meckstroth A, Keating B, Adamek K, Zaveri H, So O, et al. Factors influencing youth sexual activity: conceptual models for sexual risk avoidance and cessation. OPRE Research Brief #2020-153. Washington, DC: Office of Planning; 2020.

    Google Scholar 

  11. Buot M-LG, Docena JP, Ratemo BK, Bittner MJ, Burlew JT, Nuritdinov AR, et al. Beyond race and place: distal sociological determinants of HIV disparities. PLoS ONE. 2014;9(4):e91711. https://doi.org/10.1371/journal.pone.0091711.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Hallfors DD, Iritani BJ, Miller WC, Bauer DJ. Sexual and drug behavior patterns and HIV and STD racial disparities: the need for new directions. Am J Public Health. 2007;97(1):125–32. https://doi.org/10.2105/AJPH.2005.075747.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Obidoa C, Thompson OP, Thitsa M, Smith E, Katner H. Sexual behavior patterns of Black young adults in Georgia: results from a latent class analysis. J Racial Ethn Health Dispar. 2022. https://doi.org/10.1007/s40615-021-01217-y.

    Article  Google Scholar 

  14. Markham CM, Tortolero SR, Escobar-Chaves SL, Parcel GS, Harrist R, Addy RC. Family connectedness and sexual risk-taking among urban youth attending alternative high schools. Perspect Sex Reprod Health. 2003;35(4):174–9. https://doi.org/10.1363/psrh.35.174.03.

    Article  PubMed  Google Scholar 

  15. Banks DE, Hensel DJ, Zapolski TCB. Integrating individual and contextual factors to explain disparities in HIV/STI among heterosexual African American youth: a contemporary literature review and social ecological model. Arch Sex Behav. 2020;49(6):1939–64. https://doi.org/10.1007/s10508-019-01609-6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee on Community-Based Solutions to Promote Health Equity, Baciu A, Negussie Y, et al. The root causes of health inequity. Washington, D.C.: National Academies Press; 2017.

    Google Scholar 

  17. Pellowski JA, Kalichman SC, Matthews KA, Adler N. A pandemic of the poor: social disadvantage and the U.S. HIV epidemic. Am Psychol. 2013;68(4):197–209. https://doi.org/10.1037/a0032694.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Warner TD. Adolescent sexual risk taking: the distribution of youth behaviors and perceived peer attitudes across neighborhood contexts. J Adolesc Health. 2018;62(2):226–33. https://doi.org/10.1016/j.jadohealth.2017.09.007.

    Article  PubMed  Google Scholar 

  19. Cubbin C, Santelli J, Brindis CD, Braveman P. Neighborhood context and sexual behaviors among adolescents: findings from the national longitudinal study of adolescent health. Perspect Sex Reprod Health. 2005;37(3):125–34. https://doi.org/10.1363/psrh.37.125.05.

    Article  PubMed  Google Scholar 

  20. Bauermeister JA, Zimmerman MA, Caldwell CH. Neighborhood disadvantage and changes in condom use among African American adolescents. J Urban Health. 2011;88(1):66–83. https://doi.org/10.1007/s11524-010-9506-9.

    Article  PubMed  Google Scholar 

  21. Burgard SA, Lee-Rife SM. Community characteristics, sexual initiation, and condom use among young Black South Africans. J Health Soc Behav. 2009;50(3):293–309. https://doi.org/10.1177/002214650905000304.

    Article  PubMed  Google Scholar 

  22. Browning CR, Burrington LA, Leventhal T, Brooks-Gunn J. Neighborhood structural inequality, collective efficacy, and sexual risk behavior among urban youth. J Health Soc Behav. 2008;49(3):269–85. https://doi.org/10.1177/002214650804900303.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Brawner BM, Kerr J, Castle BF, Bannon JA, Bonett S, Stevens R, et al. A systematic review of neighborhood-level influences on HIV vulnerability. AIDS Behav. 2022;26(3):874–934. https://doi.org/10.1007/s10461-021-03448-w.

    Article  PubMed  Google Scholar 

  24. Ross CE. Disorder and decay: the concept and measurement of perceived neighborhood disorder. Urban Aff Rev. 1999;34(3):412–32. https://doi.org/10.1177/10780879922184004.

    Article  Google Scholar 

  25. Zdaniuk B. Ordinary least-squares (OLS) model. In: Encyclopedia of quality of life and well-being research. Dordrecht: Springer, Netherlands; 2014. p. 4515–7.

    Chapter  Google Scholar 

  26. Adimora AA, Schoenbach VJ. Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. J Infect Dis. 2005;191 Suppl 1(s1):S115-22. https://doi.org/10.1086/425280.

    Article  PubMed  Google Scholar 

  27. Newman PA, Zimmerman MA. Gender differences in HIV-related sexual risk behavior among urban African American youth: a multivariate approach. AIDS Educ Prev. 2000;12(4):308–25.

    CAS  PubMed  Google Scholar 

  28. Vasilenko SA, Kugler KC, Butera NM, Lanza ST. Patterns of adolescent sexual behavior predicting young adult sexually transmitted infections: a latent class analysis approach. Arch Sex Behav. 2015;44(3):705–15. https://doi.org/10.1007/s10508-014-0258-6.

    Article  PubMed  Google Scholar 

  29. Miller PK, Broman CL. Racial-ethnic differences in sexual risk behaviors: the role of substance use. J Black Sex Relatsh. 2016;3(1):25–43. https://doi.org/10.1353/bsr.2016.0020.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Ross CE, Mirowsky J. Neighborhood disorder, subjective alienation, and distress. J Health Soc Behav. 2009;50(1):49–64. https://doi.org/10.1177/002214650905000104.

    Article  PubMed  Google Scholar 

  31. Root ED. Moving neighborhoods and health research forward: using geographic methods to examine the role of spatial scale in neighborhood effects on health. Ann Assoc Am Geogr. 2012;102(5):986–95. https://doi.org/10.1080/00045608.2012.659621.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Merlo J, Chaix B, Yang M, Lynch J, Råstam L. A brief conceptual tutorial on multilevel analysis in social epidemiology: interpreting neighbourhood differences and the effect of neighbourhood characteristics on individual health. J Epidemiol Community Health. 2005;59(12):1022–8. https://doi.org/10.1136/jech.2004.028035.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Black RSA, Curran D, Dyer KFW. The impact of shame on the therapeutic alliance and intimate relationships: shame, therapeutic alliance, and intimate relationships. J Clin Psychol. 2013;69(6):646–54. https://doi.org/10.1002/jclp.21959.

    Article  PubMed  Google Scholar 

  34. Laurenceau J-P, Kleinman BM, Kaczynski KJ, Carver CS. Assessment of relationship-specific incentive and threat sensitivities: predicting satisfaction and affect in adult intimate relationships. Psychol Assess. 2010;22(2):407–19. https://doi.org/10.1037/a0019231.

    Article  PubMed  Google Scholar 

  35. Harman JJ, Smith VE, Egan LC. The impact of incarceration on intimate relationships. Crim Justice Behav. 2007;34(6):794–815. https://doi.org/10.1177/0093854807299543.

    Article  Google Scholar 

  36. Impett EA, Gable SL, Peplau LA. Giving up and giving in: the costs and benefits of daily sacrifice in intimate relationships. J Pers Soc Psychol. 2005;89(3):327–44. https://doi.org/10.1037/0022-3514.89.3.327.

  37. Lichtenstein B. Drugs, incarceration, and HIV/AIDS among African American men: a critical literature review and call to action. Am J Mens Health. 2009;3(3):252–64. https://doi.org/10.1177/1557988308320695.

    Article  PubMed  Google Scholar 

  38. Rowell-Cunsolo TL, El-Bassel N, Hart CL. Black Americans and incarceration: a neglected public health opportunity for HIV risk reduction. J Health Care Poor Underserved. 2016;27(1):114–30. https://doi.org/10.1353/hpu.2016.0011.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Ricks JM, Crosby RA, Terrell I. Elevated sexual risk behaviors among post incarcerated young African American males in the South. Am J Mens Health. 2015;9(2):132–8. https://doi.org/10.1177/1557988314532680.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We would like to thank Danielle Countryman, BA (Global Health Studies Alum of Mercer University), and Jada Moss, Global Health Student at Mercer University for the contributions they made towards the successful preparation of this manuscript.

Funding

This study was funded by a pilot Grant from the National Institutes of Mental Health (NIMH) (2014) through the Research Institute for Diverse Scholars (REIDS) Program at the Center for Interdisciplinary Research on AIDS (CIRA), Yale University. Grant #: R25MH087217.

Author information

Authors and Affiliations

  1. Department of International & Global Studies, Mercer University, 1501 Mercer University Drive, Macon, GA, 31207, USA

    Chinekwu Obidoa

  2. Department of Government & Justice Studies, Appalachian State University, 350K Anne Belk Hall, Boone, USA

    Peter Onah Thompson

  3. Department of Electrical & Computer Engineering, Mercer University, 1501 Mercer University Drive, Macon, GA, 31207, USA

    Makhin Thitsa

  4. Paul Whitfield Horn Professor Emeritus, Texas Tech University, Lubbock, USA

    Clyde F. Martin

  5. Division of Infectious Diseases, Department of Internal Medicine, Mercer University School of Medicine, Macon, GA, USA

    Harold Katner

Authors
  1. Chinekwu Obidoa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Peter Onah Thompson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Makhin Thitsa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Clyde F. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Harold Katner
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study satisfactorily. Material preparation and data collection procedures were performed by CO and supported by HK. CO, CM, and MT performed the initial data organization and analysis. PO led the multivariate analysis. The manuscript version was prepared by CO and reviewed by CM and MT. All authors approve the submission.

Corresponding author

Correspondence to Chinekwu Obidoa.

Ethics declarations

Conflict of interest

The authors have no competing interests to declare that are relevant to the content of this article.

Ethical Approval

We received institutional review board (IRB) approval before the start of the study. All co-authors contributed substantially to the paper and have approved the final version being submitted. This paper is not under review in any journal. We will be glad to provide any documents or answer any questions you may have about the study. There are no ethical problems associated with our paper. All authors and methods used followed proper ethical standards and IRB requirements.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Obidoa, C., Thompson, P.O., Thitsa, M. et al. Socio-ecologic Correlates of HIV/AIDS-Related Sexual Risk Behavior of African American Emerging Adults. AIDS Behav 27, 3392–3400 (2023). https://doi.org/10.1007/s10461-023-04055-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-023-04055-7

Keywords

Search

Navigation