Advertisement

Sex Roles

, Volume 78, Issue 7–8, pp 467–481 | Cite as

Individual, Interpersonal, and Sociostructural Factors Influencing Partner Nonmonogamy Acceptance among Young African American Women

  • Ashley C. Lima
  • Teaniese Latham Davis
  • Karen Hilyard
  • Kathleen deMarrais
  • William L. JeffriesIV
  • Jessica Legge Muilenburg
Original Article

Abstract

In 2015 in the United States, the HIV diagnosis rate among African American women was 16 times that of White women, and HIV especially affected young African American women. African American women’s partnerships with nonmonogamous men may be one factor contributing to this disparity. Previous research has not adequately described factors influencing acceptance of partner nonmonogamy among African American women. To better understand this phenomenon, we interviewed 11 African American women aged 18–24 years-old who reported having sex in the past 3 months and reported knowing or suspecting a partner to have another female partner in the past 12 months. We employed a semi-structured interview guide designed to elicit in-depth, narrative responses from women about their partnerships. We used narrative analysis to interpret findings. Participants described factors that encouraged acceptance of partner nonmonogamy. These factors were social (i.e., limited partner availability, gender norms, and cultural norms), interpersonal (i.e., partner-specific comfort, sexual connection and emotional attachment, and casual partnership type), and intrapersonal (i.e., low self-esteem, loneliness, and fatalistic attitudes about nonmonogamy) in nature. The sociocultural context in which young African American women develop sexual partnerships may influence their attitudes, expectations, and behaviors within these partnerships and place them at increased risk for HIV and other sexually transmitted infections.

Keywords

HIV/AIDS Sexually transmitted infections Concurrent sex partnerships Partner nonmonogamy African American women 

Notes

Acknowledgments

We are grateful to Laetitia Adelson and Amber Broughton for their assistance with transcription and data analysis. We offer additional thanks to Ms. Adelson for her support during the research process. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Compliance with Ethical Standards

Conflict of Interest Statement

The authors declare that they have no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

11199_2017_811_MOESM1_ESM.docx (32 kb)
ESM 1 (DOCX 31 kb)

References

  1. Adimora, A. A., & Schoenbach, V. J. (2005). Social context, sexual networks, and racial disparities in rates of sexually transmitted infections. Journal of Infectious Diseases, 191, 115–122. doi: 10.1086/425280.CrossRefGoogle Scholar
  2. Adimora, A. A., Schoenbach, V. J., Martinson, F., Donaldson, K. H., Stancil, T. R., & Fullilove, R. E. (2004). Concurrent sexual partnerships among African Americans in the rural south. Annals of Epidemiology, 14(3), 155–160. doi: 10.1016/s1047-2797(03)00129-7.CrossRefPubMedGoogle Scholar
  3. Adimora, A. A., Schoenbach, V. J., & Doherty, I. A. (2007). Concurrent sexual partnerships among men in the United States. American Journal of Public Health, 97(12), 2230–2237. doi: 10.2105/ajph.2006.099069.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Adimora, A. A., Schoenbach, V. J., Taylor, E. M., Khan, M. R., & Schwartz, R. J. (2011). Concurrent partnerships, nonmonogamous partners, and substance use among women in the United States. American Journal of Public Health, 101(1), 128–136. doi: 10.2105/ajph.2009.174292.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Adimora, A. A., Schoenbach, V. J., Taylor, E. M., Khan, M. R., Schwartz, R. J., & Miller, W. C. (2013). Sex ratio, poverty, and concurrent partnerships among men and women in the United States: A multilevel analysis. Annals of Epidemiology, 23(11), 716–719. doi: 10.1016/j.annepidem.2013.08.002.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Adimora, A. A., Hughes, J. P., Wang, J., Haley, D. F., Golin, C. E., Magnus, M., et al. (2014). Characteristics of multiple and concurrent partnerships among women at high risk for HIV infection. JAIDS, Journal of Acquired Immune Deficiency Syndromes, 65(1), 99–106. doi: 10.1097/QAI.0b013e3182a9c22a.CrossRefPubMedGoogle Scholar
  7. Andrinopoulos, K., Kerrigan, D., & Ellen, J. M. (2006). Understanding sex partner selection from the perspective of inner-city black adolescents. Perspectives on Sexual & Reproductive Health, 38(3), 132–138. doi: 10.1111/j.1931-2393.2006.tb00261.x.CrossRefGoogle Scholar
  8. Bowleg, L., Lucas, K. J., & Tschann, J. M. (2004). "the ball was always in his court": An exploratory analysis of relationship scripts, sexual scripts, and condom use among African American women. Psychology of Women Quarterly, 28(1), 70–82. doi: 10.1111/j.1471-6402.2004.00124.x.CrossRefGoogle Scholar
  9. Boyer, C. B., Shafer, M.-A. B., Pollack, L. M., Canchola, J., Moncada, J., & Schachter, J. (2006). Sociodemographic markers and behavioral correlates of sexually transmitted infections in a nonclinical sample of adolescent and young adult women. Journal of Infectious Diseases, 194(3), 307–315. doi: 10.1086/506328.CrossRefPubMedGoogle Scholar
  10. Brown, N. C., Taylor, E. D., Mulatu, M. S., & Scott, W. (2007). Demographic correlates of HIV testing, high-risk behaviors, and condom/STD consultation among a multi-ethnic sample of women. Women & Health, 46(2–3), 59–76. doi: 10.1300/j013v46n02_05.CrossRefGoogle Scholar
  11. Buot, M.-L. G., Docena, J. P., Ratemo, B. K., Bittner, M. J., Burlew, J. T., Nuritdinov, A. R., & Robbins, J. R. (2014). Beyond race and place: Distal sociological determinants of HIV disparities. PloS One, 9(4), e91711. doi: 10.1371/journal.pone.0091711.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Carey, M. P., Senn, T. E., Seward, D. X., & Vanable, P. A. (2010). Urban African-American men speak out on sexual partner concurrency: Findings from a qualitative study. AIDS and Behavior, 14(1), 38–47. doi: 10.1007/s10461-008-9406-0.CrossRefPubMedGoogle Scholar
  13. Carnegie, N. B., & Morris, M. (2012). Size matters: Concurrency and the epidemic potential of HIV in small networks. PloS One, 7(8), e43048–e43048. doi: 10.1371/journal.pone.0043048.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Cates, J. R., Francis, D. B., Ramirez, C., Brown, J. D., Schoenbach, V. J., Fortune, T., ... Powell Hammond, W. (2015). Reducing concurrent sexual partnerships among blacks in the rural southeastern United States: Development of narrative messages for a radio campaign. Journal of Health Communication, 20(11), 1264–1274. doi: 10.1080/10810730.2015.1018643.
  15. Census Bureau, U. S. (2010). American FactFinder. Census 2010 summary file 1 (SF 1): 100 percent data. Washington, DC: U.S. Census Bureau.Google Scholar
  16. Centers for Disease Control and Prevention. (2016a). HIV surveillance report, 2015 (Vol. 27). Atlanta: US Department of Health and Human Services.Google Scholar
  17. Centers for Disease Control and Prevention. (2016b). Sexually transmitted disease surveillance 2015. Atlanta: U.S. Department of Health and Human Services.Google Scholar
  18. Connell, R. (1987). Gender and power: Society, the person, and sexual politics. Chicago: Standford University Press.Google Scholar
  19. Danielson, C. K., Walsh, K., McCauley, J., Ruggiero, K. J., Brown, J. L., Sales, J. M., et al. (2014). HIV-related sexual risk behavior among African American adolescent girls. Journal of Women's Health, 23(5), 413–419. doi: 10.1089/jwh.2013.4599.CrossRefPubMedPubMedCentralGoogle Scholar
  20. D'Emilio, J., & Freedman, E. B. (1988). Intimate matters: A history of sexuality in America: University of Chicago Press.Google Scholar
  21. El-Bassel, N., & Wechsberg, W. M. (2012). Couple-based behavioral HIV interventions: Placing HIV risk-reduction responsibility and agency on the female and male dyad. Couple and Family Psychology: Research and Practice, 1(2), 94–105. doi: 10.1037/a0028890.CrossRefGoogle Scholar
  22. Fasula, A. M., Carry, M., & Miller, K. S. (2014). A multidimensional framework for the meanings of the sexual double standard and its application for the sexual health of young black women in the U.S. The Journal of Sex Research, 51(2), 170–183. doi: 10.1080/00224499.2012.716874.CrossRefPubMedGoogle Scholar
  23. Ferguson, Y. O., Quinn, S. C., Eng, E., & Sandelowski, M. (2006). The gender ratio imbalance and its relationship to risk of HIV/AIDS among African American women at historically black colleges and universities. AIDS Care, 18(4), 323–331. doi: 10.1080/09540120500162122.CrossRefPubMedGoogle Scholar
  24. Garrison, D. R., Cleveland-Innes, M., Koole, M., & Kappelman, J. (2006). Revisiting methodological issues in transcript analysis: Negotiated coding and reliability. The Internet and Higher Education, 9(1), 1–8. doi: 10.1016/j.iheduc.2005.11.001.CrossRefGoogle Scholar
  25. Glaze, L. E. (2011). Correctional populations in the United States, 2010. Washington, DC: Bureau of Justice Statistics.Google Scholar
  26. Gorbach, P. M., Stoner, B. P., Aral, S. O., H Whittington, W. L., & Holmes, K. K. (2002). "it takes a village": Understanding concurrent sexual partnerships in Seattle, Washington. Sexually Transmitted Diseases, 29(8), 453–462. doi: 10.1097/00007435-200208000-00004.CrossRefPubMedGoogle Scholar
  27. Gorbach, P. M., Drumright, L. N., & Holmes, K. K. (2005). Discord, discordance, and concurrency: Comparing individual and partnership-level analyses of new partnerships of young adults at risk of sexually transmitted infections. Sexually Transmitted Diseases, 32(1), 7–12. doi: 10.1097/01.olq.0000148302.81575.fc.CrossRefPubMedGoogle Scholar
  28. Grieb, S. M. D., Davey-Rothwell, M., & Latkin, C. A. (2012). Concurrent sexual partnerships among urban African American high-risk women with main sex partners. AIDS and Behavior, 16(2), 323–333. doi: 10.1007/s10461-011-9954-6.CrossRefPubMedPubMedCentralGoogle Scholar
  29. Hallfors, D. D., Iritani, B. J., Miller, W. C., & Bauer, D. J. (2007). Sexual and drug behavior patterns and HIV and STD racial disparities: The need for new directions. American Journal of Public Health, 97(1), 125–132. doi: 10.2105/ajph.2005.075747.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Harper, C. R., Dittus, P. J., Leichliter, J. S., & Aral, S. O. (2017). Changes in the distribution of sex partners in the United States: 2002 to 2011–2013. Sexually Transmitted Diseases, 44(2), 96–100. doi: 10.1097/OLQ.0000000000000554.CrossRefPubMedGoogle Scholar
  31. Harris, G., Mallory, C., & Stampley, C. (2010). A qualitative study of man-sharing and the implications for midlife African American women's risk for HIV infection. Women & Health, 50(7), 670–687. doi: 10.1080/03630242.2010.520253.CrossRefGoogle Scholar
  32. Hill Collins, P. (2005). Black sexual politics: African Americans, gender, and the new racism. New York: Routledge.Google Scholar
  33. Hill Collins, P. (2009). Black feminist thought: Knowledge, consciousness, and the politics of empowerment. New York: Routledge.Google Scholar
  34. Hotton, A. L., French, A. L., Hosek, S. G., Kendrick, S. R., Lemos, D., Brothers, J., et al. (2015). Relationship dynamics and sexual risk reduction strategies among heterosexual young adults: A qualitative study of sexually transmitted infection clinic attendees at an urban Chicago health center. AIDS Patient Care and STDs, 29(12), 668–674. doi: 10.1089/apc.2015.0146.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Jones, R., & Oliver, M. (2007). Young urban women's patterns of unprotected sex with men engaging in HIV risk behaviors. AIDS and Behavior, 11(6), 812–821. doi: 10.1007/s10461-006-9194-3.CrossRefPubMedGoogle Scholar
  36. Laumann, E. O., & Youm, Y. (1999). Racial/ethnic group differences in the prevalence of sexually transmitted diseases in the United States: A network explanation. Sexually Transmitted Diseases, 26(5), 250–261. doi: 10.1097/00007435-199905000-00003.CrossRefPubMedGoogle Scholar
  37. Lenoir, C. D., Adler, N. E., Borzekowski, D. L. G., Tschann, J. M., & Ellen, J. M. (2006). What you don't know can hurt you: Perceptions of sex-partner concurrency and partner-reported behavior. Journal of Adolescent Health, 38(3), 179–185. doi: 10.1016/j.jadohealth.2003.11.063.CrossRefPubMedGoogle Scholar
  38. Macauda, M. M., Erickson, P. I., Singer, M. C., & Santelices, C. C. (2011). A cultural model of infidelity among African American and Puerto Rican young adults. Anthropology & Medicine, 18(3), 351–364. doi: 10.1080/13648470.2011.615908.CrossRefGoogle Scholar
  39. Manhart, L. E., Aral, S. O., Holmes, K. K., & Foxman, B. (2002). Sex partner concurrency: Measurement, prevalence, and correlates among urban 18-39-year-olds. Sexually Transmitted Diseases, 29(3), 133–143. doi: 10.1097/00007435-200203000-00003.CrossRefPubMedGoogle Scholar
  40. McLellan-Lemal, E., Toledo, L., O'Daniels, C., Villar-Loubet, O., Simpson, C., Adimora, A. A., … Marks, G. (2013). "A man's gonna do what a man wants to do": African American and Hispanic women's perceptions about heterosexual relationships: A qualitative study. BMC Women's Health, 13(1), 27, 1-14. doi: 10.1186/1472-6874-13-27.
  41. Morris, M., & Kretzschmar, M. (1995). Concurrent partnerships and transmission dynamics in networks. Social Networks, 17(3), 299–318. doi: 10.1016/0378-8733(95)00268-s.CrossRefGoogle Scholar
  42. Morris, M., Kurth, A. E., Hamilton, D. T., Moody, J., & Wakefield, S. (2009). Concurrent partnerships and HIV prevalence disparities by race: Linking science and public health practice. American Journal of Public Health, 99(6), 1023–1031. doi: 10.2105/ajph.2008.147835.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Nunn, A., Dickman, S., Cornwall, A., Rosengard, C., Kwakwa, H., Kim, D., ... Mayer, K. R. (2011). Social, structural and behavioral drivers of concurrent partnerships among African American men in Philadelphia. AIDS Care, 23(11), 1392–1399. doi: 10.1080/09540121.2011.565030.
  44. Nunn, A., Dickman, S., Cornwall, A., Kwakwa, H., Mayer, K. H., & Rosengard, C. (2012). Concurrent sexual partnerships among African American women in Philadelphia: Results from a qualitative study. Sexual Health, 9(3), 288–296. doi: 10.1071/sh11099.CrossRefPubMedPubMedCentralGoogle Scholar
  45. Oser, C. B., Pullen, E., Stevens-Watkins, D., Perry, B. L., Havens, J. R., Staton-Tindall, M., et al. (2016). African American women and sexually transmitted infections: The contextual influence of unbalanced sex ratios and individual risk behaviors. Journal of Drug Issues. doi: 10.1177/0022042616678610.
  46. Paik, A. (2010). The contexts of sexual involvement and concurrent sexual partnerships. Perspectives on Sexual ond Reproductive Health, 42(1), 33–42. doi: 10.1363/4203310.CrossRefGoogle Scholar
  47. Paltiel, A. D., Freedberg, K. A., Scott, C. A., Schackman, B. R., Losina, E., Wang, B., et al. (2009). HIV Preexposure prophylaxis in the United States: Impact on lifetime infection risk, clinical outcomes, and cost effectiveness. Clinical Infectious Diseases, 48(6), 806–815. doi: 10.1086/597095.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Patton, M. Q. (1999). Enhancing the quality and credibility of qualitative analysis. Health Services Research, 34(5 Pt 2), 1189–1208 Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1089059/.PubMedPubMedCentralGoogle Scholar
  49. Paxton, K. C., Williams, J. K., Bolden, S., Guzman, Y., & Harawa, N. T. (2013). HIV risk behaviors among African American women with at-risk male partners. Journal of AIDS and Clinical Research, 4(7), 221–221. doi: 10.4172/2155-6113.1000221.PubMedPubMedCentralGoogle Scholar
  50. Polkinghorne, D. (1995). Narrative configuration in qualitative analysis. International Journal of Qualitative Studies in Education (QSE), 8(1), 5–23. doi: 10.1080/0951839950080103.CrossRefGoogle Scholar
  51. Pouget, E. R., Kershaw, T. S., Ickovics, J. R., & Blankenship, K. M. (2010). Associations of sex ratios and male incarceration rates with multiple opposite-sex partners: Potential social determinants of HIV/STI transmission. Public Health Reports, 125(4-suppl), 70–80. doi: 10.1177/00333549101250s411.CrossRefPubMedPubMedCentralGoogle Scholar
  52. Raiford, J. L., Seth, P., & DiClemente, R. J. (2013). What girls won't do for love: Human immunodeficiency virus/sexually transmitted infections risk among young African-American women driven by a relationship imperative. Journal of Adolescent Health, 52(5), 566–571. doi: 10.1016/j.jadohealth.2012.09.006.CrossRefPubMedGoogle Scholar
  53. Salazar, L. F., Crosby, R. A., DiClemente, R. J., Wingood, G. M., Lescano, C. M., Brown, L. K., ... Davies, S. (2005). Self-esteem and theoretical mediators of safer sex among African American female adolescents: Implications for sexual risk reduction interventions. Health Education & Behavior, 32(3), 413–427. doi: 10.1177/1090198104272335.
  54. Sanchez, D. M., Schoenbach, V. J., Harvey, S. M., Warren, J. T., Adimora, A. A., Poole, C., ... Agnew, C. R. (2015). Association of perceived partner non-monogamy with prevalent and incident sexual concurrency. Sexually Transmitted Infections, 92(4), 266–271. doi: 10.1136/sextrans-2015-052111.
  55. Senn, T. E., Scott-Sheldon, L. A., Seward, D. X., Wright, E. M., & Carey, M. P. (2011). Sexual partner concurrency of urban male and female STD clinic patients: A qualitative study. Archives of Sexual Behavior, 40(4), 775–784. doi: 10.1007/s10508-010-9688-y.CrossRefPubMedGoogle Scholar
  56. Shrier, L. A., Harris, S. K., Sternberg, M., & Beardslee, W. R. (2001). Associations of depression, self-esteem, and substance use with sexual risk among adolescents. Preventive Medicine, 33(3), 179–189. doi: 10.1006/pmed.2001.0869.CrossRefPubMedGoogle Scholar
  57. Smith, T. K. (2015). Sexual protective strategies and condom use in middle-aged African American women: A qualitative study. Journal of the Association of Nurses in AIDS Care, 26(5), 526–541. doi: 10.1016/j.jana.2015.05.006.CrossRefPubMedPubMedCentralGoogle Scholar
  58. Stephenson, R., Sullivan, P. S., Salazar, L. F., Gratzer, B., Allen, S., & Seelbach, E. (2011). Attitudes towards couples-based HIV testing among MSM in three US cities. AIDS and Behavior, 15(1), 80–87. doi: 10.1007/s10461-011-9893-2.CrossRefGoogle Scholar
  59. Thompson-Robinson, M. V., Richter, D. L., Shegog, M. L., Weaver, M., Trahan, L., Sellers, D. B., & Brown, V. L. (2005). Perceptions of partner risk and influences on sexual decision-making for HIV prevention among students at historically Black colleges and universities. Journal of African American Studies, 9(2), 16–28. doi: 10.1007/s12111-005-1019-3.CrossRefGoogle Scholar
  60. UNAIDS Reference Group on Estimates, Modelling, and Projections: Working Group on Measuring Concurrent Sexual Partnerships. (2010). HIV: Consensus indicators are needed for concurrency. The Lancet, 375(9715), 621–622. doi: 10.1016/S0140-6736(09)62040-7.CrossRefGoogle Scholar
  61. Waldrop-Valverde, D. G., Davis, T. L., Sales, J. M., Rose, E. S., Wingood, G. M., & DiClemente, R. J. (2013). Sexual concurrency among young African American women. Psychology, Health & Medicine, 18(6), 676–686. doi: 10.1080/13548506.2013.764462.CrossRefGoogle Scholar
  62. Wingood, G. M., & DiClemente, R. J. (2000). Application of the theory of gender and power to examine HIV-related exposures, risk factors, and effective interventions for women. Health Education & Behavior, 27(5), 539–565. doi: 10.1177/109019810002700502.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Ashley C. Lima
    • 1
  • Teaniese Latham Davis
    • 2
  • Karen Hilyard
    • 3
  • Kathleen deMarrais
    • 4
  • William L. JeffriesIV
    • 1
  • Jessica Legge Muilenburg
    • 3
  1. 1.Division of HIV/AIDS PreventionNational Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and PreventionAtlantaUSA
  2. 2.Morehouse CollegePublic Health Sciences InstituteAtlantaUSA
  3. 3.Department of Health Promotion and BehaviorUniversity of GeorgiaAthensUSA
  4. 4.Department of Lifelong Education, Administration, and PolicyUniversity of GeorgiaAthensUSA

Personalised recommendations