Sexual risk behavior and STI health literacy among ethnic minority adolescent women

doi:10.1016/j.apnr.2013.06.003

Applied Nursing Research

Volume 26, Issue 4, November 2013, Pages 204-209

https://doi.org/10.1016/j.apnr.2013.06.003 Get rights and content

Abstract

Although information is available for prevention of sexually transmitted infection (STI/HIV), adolescents continue to engage in high risk sexual behavior particularly ethnic minority adolescent women with histories of STI or abuse. A description therefore of STI/HIV knowledge and sexual risk behavior among these women is indicated for modification of prevention efforts for sexual health promotion. African-American (n = 94) and Mexican-American (n = 465) adolescent women 14–18 years of age were included in the study. Assessments of sexual risk behavior and STI/HIV knowledge among these adolescent women described Mexican-American women as at higher risk of STI, pregnancy, substance use and abuse with lower levels of STI/HIV knowledge, previous HIV testing and perceptions of risk than African-American women. A focus on Mexican-American adolescent women with histories of STI and abuse is indicated for translation of community-based health promotion interventions for amelioration of potential adverse sexual health outcomes among ethnic minority adolescent women.

Introduction

Ethnic minority adolescent women in the United States of America disproportionately experience sexually transmitted infections (STI) including human immunodeficiency virus (HIV). African-American (AA) women are nearly 15 times more likely than non-Hispanic White women to be infected with HIV while Hispanic women are four times more likely than non-Hispanic White women to be infected. African-American and Hispanic women 15–19 years of age with a history of STI or sexual or physical abuse are at highest risk for STI including HIV compared to other ethnicities and older women (Centers for Disease Control and Prevention, 2010a, Centers for Disease Control and Prevention, 2010b, Centers for Disease Control and Prevention, 2010c, Champion, 2011, Champion and Collins, 2012a, Champion and Collins, 2012b, Freeman, 2010, Hou, 2009). Assessment of knowledge concerning STI/HIV transmission and sexual risk behavior among ethnic minority adolescent women is important for provision of effective STI/HIV prevention efforts. The purpose of this study was to describe STI/HIV knowledge and sexual risk behavior among AA and Mexican-American (MA) adolescent women with a history of STI or abuse (sexual, physical or emotional). This information may be utilized for modification of HIV/STI sexual risk reduction interventions within community health care settings.

Section snippets

Background

Sexual risk behavior has been assessed among AA and Hispanic adolescent women with findings indicating early age of first sexual encounter and high numbers of sexual partners (Champion, 2011, Villarruel et al., 2005), unprotected vaginal sex with steady partners, and lower levels of knowledge regarding condom usage despite high levels of STI/HIV knowledge (Crosby et al., 2000, Jermmott et al., 2005). Brown, Lourie, Flanagan, and High (1998) found lower use of condoms among AA and Hispanic

Methods

This study was approved by the institutional review boards at The University of Texas Health Science Center and the San Antonio Metropolitan Health District (SAMHD), (Champion and Collins, 2012a, Champion and Collins, 2012b). Adolescent AA or MA women accessing care at the SAMHD STI or public health clinics who had either an STI or abuse (physical, sexual, emotional) history were referred for potential study participation. Eligibility was limited to English speaking women in order to maximize

Demographics

African-American (n = 94, 16.8%) and MA (n = 465, 83.2%) adolescent women 14–18 years of age were included in the study. Demographic characteristics are included in Table 1 with inclusion of descriptions by ethnicity. There was no difference in mean age between ethnicities. However, significantly more MA women were not in school or unemployed or had ever runaway. Significantly more MA women had ever used a birth control method. More MA women had been pregnant in the past while equivalent numbers of

Discussion

Theoretical and empirical support from decades of descriptive research associates STI/HIV prevention, acquisition and resolution with multiple psychosocial and situational factors (Champion, 2007, Champion et al., 2005, Koniak-Griffin et al., 2003, Roye et al., 2007). Results from this study are consistent with prior research describing a high incidence of sexual risk and STI sequelae for ethnic minority adolescent women.

As in previous adaptations of the AIDS Risk Reduction Model for use among

Conclusions

Descriptions of sexual risk behavior and STI/HIV knowledge among ethnic minority adolescent women with histories of STI or sexual, physical or emotional abuse portrayed MA women with higher levels of STI, pregnancy, substance use and abuse and lower levels of STI/HIV knowledge, previous HIV testing and perceptions of risk than AA. Tailoring of STI/HIV community-based health promotion interventions for MA and AA adolescent women with histories of STI and abuse is indicated for amelioration of