title: What girls won't do for love: human immunodeficiency virus/sexually transmitted infections risk among young African-American women driven by a relationship imperative.
abstract: OBJECTIVE
  Rates of Human immunodeficiency virus (HIV) and other sexually transmitted infections (STIs) continue to increase among African-American youth. Adolescents who have a stronger identity in relation to others (relational identity) rather than to themselves (self-identity) may view intimate relationships as imperative to a positive self-concept, which may lead to risky sexual behavior and abuse. Therefore, the present study assessed the associations among a relationship imperative and HIV/STI-related risk factors and behaviors.
  
  
  METHODS
  Participants were 715 African-American adolescent females, aged 15 to 21 years. They completed measures that assessed how important a relationship was to them and HIV-related risk factors and behaviors. Participants also provided vaginal swab specimens for STI testing.
  
  
  RESULTS
  Multivariate logistic regression analyses, controlling for covariates, were conducted. Females who endorsed a relationship imperative (29%), compared to those who did not, were more likely to report: unprotected sex, less power in their relationships, perceived inability to refuse sex, anal sex, sex while their partner was high on alcohol/drugs, and partner abuse. Furthermore, participants with less power, recent partner abuse, and a perceived ability to refuse sex were more likely to test STI positive.
  
  
  CONCLUSIONS
  These results indicate that if African-American adolescent females believe a relationship is imperative, they are more likely to engage in riskier sexual behaviors. Additionally, less perceived power and partner abuse increases their risk for STIs. HIV/STI prevention programs should target males and females and address healthy relationships, sense of self-worth, self-esteem and the gender power imbalance that may persist in the community along with HIV/STI risk.
authors.affiliation: Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. jraiford@cdc.gov
authors.forename: Jerris L
authors.initials: JL
authors.lastname: Raiford
authors.forename: Puja
authors.initials: P
authors.lastname: Seth
authors.forename: Ralph J
authors.initials: RJ
authors.lastname: DiClemente
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001741:Black or African American / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006801:Humans; D016015:Logistic Models; D008149:Love; D008297:Male; D011209:Power, Psychological; D000297:Psychology, Adolescent; D012307:Risk Factors; D012309:Risk-Taking; D012649:Self Concept; D012725:Sexual Behavior; D012747:Sexual Partners; D015229:Sexually Transmitted Diseases, Viral / Q000635:transmission*; D055815:Young Adult