Article
African-American sexual minority adolescents and sexual health disparities: An exploratory cross-sectional study

https://doi.org/10.1016/j.jnma.2018.11.001Get rights and content

Abstract

Purpose

To better understand sexual health disparities among African-American sexual minority adolescents.

Methods

African-American adolescents (N = 1120; mean age = 15.24 years) were recruited from 4 cities (Columbia, SC; Macon, GA; Providence, RI; Syracuse, NY) to a larger trial. The current analyses used data from the 18-month follow-up when adolescents reported on their sexual partnerships, condom use knowledge, self-efficacy and outcome expectancies for condom use, sexual risk behavior, and STI testing history.

Results

Compared with heterosexual adolescents, sexual minority adolescents reported more concerns about potential relationship harms resulting from safer sex negotiation. Sexual minority adolescents were also more likely to engage in riskier sexual behaviors, with females reporting more sexual partners and drug use prior to sex, and males reporting inconsistent condom use and higher rates of HIV.

Conclusions

African-American sexual minority adolescents evidence disparities in sexual risk behavior and STI history that appear to result from interpersonal and relationship concerns. These concerns need to be targeted in sexual health interventions for sexual minority adolescents.

Section snippets

Method

This project recruited African-American adolescents aged 14–17 years from 4 U. S. cities (i.e., Macon, GA; Providence, RI; Columbia, SC; Syracuse, NY).20 The current analysis used data from the 18-month follow-up because several of the constructs were only assessed at this time point and long-term follow-up afforded the most opportunities for sexual debut to occur.

Results & discussion

Ninety-three females (10% of all females) and 37 males (6% of all males) reported sexual experience with male and female sexual partners.

Table 1 summarizes (a) the psychological antecedents of sexual risk behavior, (b) sexual risk behaviors, (c) HIV testing behaviors and concerns, and (d) STI diagnoses (self-reported and laboratory confirmed) as a function of gender and sexual minority status.

Discussion

Prior research has established that SMA are more likely to experience STIs and unintended pregnancies relative to heterosexual youth. Results from the current study provide empirical information that helps to explain these disparities by demonstrating that levels of sexual health knowledge, expectancies, implementation self-efficacy, and sexual risk behaviors differ by sexual minority status among African-American adolescents.

The current findings highlight that, even among an at-risk population

Acknowledgements

This work was supported by the National Institute of Mental Health [1U01MH066809-01A2].

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