Impact of Relationship Control on Sexual Health Communication and Condom Negotiation for African American Girls in Detention

Background and Purpose:

Intimate partner violence (IPV) experienced by adolescent girls intersects with inconsistent condom use, thus increasing their risk of HIV/STI infection (Campbell et al., 2008). Partly due to structural inequalities and neighborhood disadvantages that also increase their risk of involvement with juvenile court systems, African American girls and young women are more likely to contract HIV/STIs (CDC, 2014) and are at elevated risk for harm by a current/former intimate partner (Black et al., 2011). High relationship control wielded by a romantic partner is an important dimension of unhealthy relationships and a potential indicator of IPV. Traumas such as IPV histories in conjunction with STI infections are especially pronounced among girls in the juvenile justice system, however, the link between relationship control and detained African American girls’ sexual health communication and negotiation is understudied. The current study explores whether relationship control experienced by detained African American girls is associated with higher fear of condom negotiation and lower partner communication self-efficacy.

Methods:

Baseline data for a larger sexual health study were collected from African American adolescent girls (N=188) in a juvenile detention facility. Participants were between the ages of 13 and 17 years old (M=15.3) and had engaged in vaginal intercourse prior to detention.

Factor analysis was conducted to streamline a relationship control scale. Next, bivariate correlations explored relationships among all major study variables. Separate hierarchical linear regressions were computed to assess the relationship between partner control and two dependent variables, fear of condom negotiation and partner communication self-efficacy. All regression analyses controlled for demographic variables (age, living situation, family aid) and family factors (caregiver support, parental monitoring, parental communication about sex). Next, individual variables (self-esteem, abuse history) were introduced into the model followed by relational/peer variables (relationship control, bullying, social support).

Results:

Bivariate analysis indicated relationship control was significantly positively correlated with fear of condom negotiation and negatively correlated with partner communication self-efficacy. The two hierarchical linear regression models accounted for 35% (R²=0.354) of the variance for fear of condom negotiation and 31% (R²=0.311) of the variance for communication self-efficacy. For the fear of condom negotiation model, relationship control (beta=0.453) and peer bullying (beta=0.140) were the most significant contributors. For the partner communication self-efficacy model, parental communication about sex was significant at each stage of the hierarchical regression (beta=0.195). Self-esteem (beta=0.353) and relationship control (beta=-0.239) were the most significant variables in this second model.

Conclusions and Implications:

Results suggest relationship control by partners is correlated with detained girls’ fear of negotiating condom use and their competency to communicate about safer sex practices. Therefore, educating girls about healthy interactions with dating partners and supporting girls’ caregivers to increase their communication about sexual activity may serve to reduce HIV/STI risk. Practice implications include developing interventions that elevate detained girls’ self-esteem, diminish bullying, and reduce gendered power differentials between partners. Male sexual partners may also be incorporated in joint interventions with female partners as a means of addressing HIV/STI incidence among incarcerated African American girls.