Racial Pride and Condom Use in Post-Incarcerated African-American Men Who Have Sex With Men and Women: Test of a Conceptual Model for the Men in Life Environments Intervention.
African-American men who have sex with men and women (MSMW) are among those most heavily impacted by HIV in the United States, and those who have histories of incarceration are at further risk of infection. The Men in Life Environments (MILE) HIV prevention intervention was developed to provide culturally appropriate skills-based education and support for African-American MSMW with recent histories of incarceration. The MILE's conceptual framework was informed by three theories: Theory of Reasoned Action and Planned Behavior, Critical Thinking and Cultural Affirmation Model, and Empowerment Theory. The theory-based framework posits that improving racial pride is crucial in building self-efficacy and intentions that in turn promote health-protective behaviors. Therefore, our study aimed to assess whether baseline associations between racial pride and condom use self-efficacy, intentions, and behaviors among African-American MSMW with histories of incarceration align with our conceptual model. We report data on 212 participants recruited from Los Angeles County Sheriff's Department Men's Central Jail and the local community. Using structural equation modeling, we tested two separate models: one with female sexual partners and one with male sexual partners, while stratifying by participant's HIV status. Only among HIV-negative participants was greater racial pride associated with less condomless intercourse with men. In this group, greater self-efficacy and intentions-but not racial pride-predicted less condomless intercourse with women. Our findings suggest that racial pride is an important factor to address in HIV prevention interventions for post-incarcerated African-American MSMW.
Division of Health Behavior Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, 3rd Floor, Los Angeles, CA, 90032-3628, USA. limichae@usc.edu.
Michael J
0000-0003-2457-604X
MJ
Li
Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, USA.
Heather Guentzel
HG
Frank
Department of Psychiatry, College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.|Department of Medicine, UCLA Geffen School of Medicine, Los Angeles, CA, USA.
Nina T
NT
Harawa
Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, UCLA, Los Angeles, CA, USA.
John K
JK
Williams
Division of Health Behavior Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, 3rd Floor, Los Angeles, CA, 90032-3628, USA.|School of Social Work, University of Southern California, Los Angeles, CA, USA.
Chih-Ping
CP
Chou
Division of Health Behavior Research, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto Street, 3rd Floor, Los Angeles, CA, 90032-3628, USA.
Ricky N
RN
Bluthenthal
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D001727:Bisexuality / Q000208:ethnology* / Q000523:psychology / Q000706:statistics & numerical data; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data*; D004644:Emotions; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D033182:Intention; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D021841:Safe Sex / Q000706:statistics & numerical data*; D020377:Self Efficacy; D012933:Social Identification; D014481:United States; D055815:Young Adult
African-American; Bisexuality; Condom use; HIV prevention; Incarceration; Racial pride