Harmful alcohol use and alcohol-related sex expectancies as predictors of risky sex among african american female college drinkers

Racial Discrimination and Risky Sex: Examining Cognitive-Emotional Factors in Black College Students

Using the lifespan biopsychosocial model of cumulative vulnerability and minority health as a theroretical lens, the present study proposed two models to test the relationships among racial discrimination, cognitive–emotional factors, and risky sexual behaviors in a sample of 302 Black college students in the United States. Our models provided support for some of the hypothesized direct and indirect pathways. As expected, overt racial discrimination and subtle racial discrimination (i.e., racial microaggression) were both positively related to cognitive–emotional factors (i.e., anxiety, depression, hopelessness, and hostility). Racial microaggressions were significantly positively related to risky sexual behaviors, but overt racial discrimination was not. Hostility was the only cognitive–emotional factor that facilitated an indirect, significant effect from racial microaggressions to risky sexual behaviors. Potential implications are discussed for practice, training programs, and future counseling psychology research with Black college students using the lifespan biopsychosocial model of cumulative vulnerability and minority health.

A Systematic Review Exploring Racial Disparities, Social Determinants of Health, and Sexually Transmitted Infections in Black Women

OBJECTIVE

To explore and describe racial disparities, the role of social determinants of health, and individual risk behaviors among Black women as related to sexual health and/or sexually transmitted infections (STIs).

DATA SOURCES

Electronic resource databases used were PubMed, CINAHL, and Google Scholar. Peer-reviewed articles published during 2010 to 2020 were considered.

STUDY SELECTION

Thirty-two studies met the criteria and included data for a total of 18,904 Black women.

DATA EXTRACTION

Data were extracted from each study using the subheadings author (year), purpose, design, sample demographics and setting, key measures, key findings, and quality assessment. In addition, PRISMA-E and PROGRESS-Plus guided data extraction to illustrate health inequity.

DATA SYNTHESIS

Black women who were more likely to report having an STI over the course of their lifetime engaged in behaviors associated with greater risk, the most common of which were unprotected sex, disproportionate partner power, and substance abuse. The primary social determinants of health associated with increased risk were lower income and lower levels of education. Black women were less likely to discuss or feel comfortable discussing their sexual health with health care providers. By contrast, engagement in safe sexual practices stemmed from internal, social, and relationship factors.

CONCLUSION

Identifying Black women who are at risk of contracting an STI is essential in driving clinical decision-making. Health care providers should be cognizant of the long-standing mistrust that Black women have of health care providers and, therefore, work to establish positive respectful and trusting relationships with open communication.

Youths' Perceptions Of The Relation Between Alcohol Consumption And Risky Sexual Behaviour in the Western Cape, South Africa: A Qualitative Study

The purpose of this study is to explore the factors that youth identify as contributing to alcohol consumption, and more specifically its relation to risky sexual behaviour among youth. We employed an exploratory qualitative method using focus group discussions with 34 young people between the ages of 18-25-years-old in low socio-economic status communities in the Western Cape province of South Africa. Data were analyzed thematically utilizing Braun and Clarke's (2006) six-step thematic analysis process. We identified two thematic domains pertaining to alcohol consumption and risky sexual behaviour, namely individual and social factors, each comprising three themes. The individual factors thematic domain comprises intrapersonal influences, employment and educational attainment; while the social factors thematic domain includes interpersonal influences, social influences, and hope for the future. Youth living in low socio-economic status communities were thought to be at greater risk of alcohol misuse and subsequent risky behaviour, given the political and social history of marginalisation, systematic oppression, and social inequality. To address alcohol use and risky sexual behavior among youth, we recommend interventions with adolescents, parents or guardians, and the community. More specifically, interventions aimed at adolescents should focus on the transition to young adulthood. Interventions with parents should focus on their role in modelling and potentially regulating alcohol consumption. Finally, community interventions should centre on drinking behaviors, levels of drinking, what constitutes harmful drinking, and how to identify when treatment and recovery support is likely to be required.

Contraceptive use and associated factors among sexually active reproductive age HIV positive women attending ART clinic at Felege Hiwot Referral Hospital, Northwest Ethiopia: A cross-sectional study

BACKGROUND

Contraception helps prevent unplanned pregnancies and mother to child Human Immune Virus (HIV) transmission among human immune virus positive women. Ethiopia has made remarkable progress in increasing contraceptive use rate but there is still a disparity of contraceptive use within the country. Although there were some studies about contraceptive use in Ethiopia, evidences about contraceptive use among sexually active HIV positive women was limited. Understanding the extent of and barriers in Ethiopia is important for learning how to best improve level of contraceptive use. Therefore, this study aimed to assess contraceptives use and associated factors among HIV positive sexually active women at anti-retroviral therapy clinic at Felege Hiwot Referral Hospital ART clinic in Bahir Dar, Ethiopia.

METHOD

A facility-based cross-sectional study was conducted from June 01-30, 2018 among (n = 308) randomly selected HIV positive women at Felege Hiwot Referral Hospital. Data were collected using a pretested interviewer-administered questionnaire and analyzed using SPSS version 20. Survey logistic regression analysis was employed to identify determinants of contraceptive use. Statistical significance was declared at p-value <0.05.

RESULTS

Out of three hundred eight participants, 118 (38.3%) reported contraceptive use at the time of the study. Injectable is the most preferred (43.5%) contraceptive method. Participants with age 15-34 years (AOR = 3.09, 95%CI: 1.59-5.99), disclosed their status to sex partner, (AOR = 2.7, 95%CI: 1.14-6.66), had history of contraception use; (AOR = 3.36, 95%CI: 1.68-6.74), were sexually active (AOR = 5.45, 95%CI: 2.72-10.91) had higher odds of contraceptive use. However, participants who had drinking habit (AOR = 4.35, 95%CI: 1.82-10.38) had lower odds of contraceptive use.

CONCLUSION

A significant proportion of HIV positive women had low level of contraceptive use that was lower than the national recommended level. Participants with younger age (15-34years), who disclosed HIV status to sex partner, had history of contraceptive use, and who were sexually active six months prior to the study were more likely to use contraception. However, participants who had drinking habit were less likely to use contraception. These results suggest that multi-sectorial and multi-disciplinary approaches are needed to increase contraceptive use in the HIV positive women.

Perceived Discrimination and Risk Behaviors in African American Students: the Potential Moderating Roles of Emotion Regulation and Ethnic Socialization

Prior research has identified perceived discrimination as being a contributing factor in health and mental health disparities. However, there is little research on the relationship between perceived discrimination and behaviors such as hazardous alcohol and illicit substance use and risky sexual behaviors that put people at risk for negative health consequences including HIV. The current research explores the role that cultural factors may play in a tendency for individuals to engage in unhealthy behaviors or an ability to avoid them. A total of 266 college students who self-identified as Black or African American were surveyed on measures of familial ethnic socialization, perceived discrimination, emotion regulation, substance use, and risky sexual behaviors. Findings indicate that perceived discrimination and emotion regulation-suppression were associated with higher levels of hazardous alcohol use, and that emotion regulation-cognitive reappraisal was associated with lower levels of illicit substance use. Implications for intervention and prevention in African American college students are discussed.

The Moderating Effects of College Stress on the Relationship between Protective Behavioral Strategies and Alcohol Outcomes

Background: Protective behavioral strategies (PBS) are harm reduction strategies used to lessen the negative effects of alcohol consumption. PBS controlled consumption (e.g., avoiding shots) center on managing alcohol consumption and tend to be negatively correlated with hazardous drinking whereas PBS serious harm reduction (e.g., having a designated driver) have a negative association with alcohol-related negative consequences. These relationships are often attenuated by factors such as mental health. Stress is linked with hazardous drinking and is experienced by most individuals. However, there are unique aspects of alcohol use and stressors associated with being in college (e.g., adjustment, academics) that require further investigation. Objectives: The purpose of this study was to explore how college stress - specific stressors related to the college experience - moderated the relationships PBS types had with hazardous drinking and alcohol-related negative consequences while accounting for gender. Methods: Participants were 550 college students ages 18 to 24 who drank alcohol within 30 days of completing measures of PBS use, college stress, hazardous drinking, and alcohol-related negative consequences. Results: A negative association was found between PBS controlled consumption and hazardous drinking while a positive association was found between PBS serious harm reduction and hazardous drinking, but neither relationships were significantly moderated by college stress. A negative relationship was found between PBS serious harm reduction and alcohol-related negative consequences, which was strengthened for those with high levels of college stress. Conclusion: These findings highlight the importance of further investigating the role of college stress in relation to safe and hazardous drinking and provide evidence for the protective role of PBS for college students experiencing stress and consuming alcohol.