Effects of fear of abuse and possible STI acquisition on the sexual behavior of young African American women

Objectives. We examined the interactive effects of fear of abuse and knowledge of sexually transmitted infections (STIs) on sexual risk behaviors in a sample of young African American women. Methods. We recruited 715 young African American women aged 15 to 21 years from a variety of health clinics and assessed them for fear of abuse because of negotiating condom use, knowledge of STIs, and several sexual risk behaviors. Results. Overall, 75% of young African American women reported inconsistent condom use in the past 60 days. Surprisingly, under relatively higher levels of fear, young women with high STI knowledge were more likely than were those with low STI knowledge to exhibit inconsistent condom use in the past 60 days (89% vs 80%; χ²=4.32; P≤.04) and during the last sexual intercourse with a main sexual partner (76% vs 70%; χ²=8.06; P≤.01). Conclusions. Most HIV prevention interventions focus on increasing knowledge about the transmission of STIs. However, other contextual factors such as fear of abuse because of negotiating condom use may heighten the risk of HIV infection. Our findings highlight the need for combining dating violence prevention activities with STI and HIV prevention programs targeting young African American women.