religiosity, ethnic identity, and risky sexual behavior in an african american church-affiliated ...

109 Pages·2012·0.69 MB·English

by  Starlyn Hawes

RELIGIOSITY, ETHNIC IDENTITY, AND RISKY SEXUAL BEHAVIOR IN AN

AFRICAN AMERICAN CHURCH-AFFILIATED POPULATION

A DISSERTATION IN
Clinical Health Psychology

Presented to the Faculty of the University
Of Missouri-Kansas City in the partial fulfillment of
the requirements for the degree

DOCTOR OF PHILOSOPHY

by
STARLYN MONTEZ HAWES

B.A., San Diego State University, 2004
M.A., University of Missouri-Kansas City, 2010

Kansas City, Missouri
2012
© 2012

STARLYN MONTEZ HAWES

ALL RIGHTS RESESRVED
RELIGIOSITY, ETHNIC IDENTITY, AND RISKY SEXUAL BEHAVIOR

IN AN AFRICAN AMERICAN CHURCH-AFFILIATED POPULATION

Starlyn Montez Hawes, Candidate for the Doctor of Philosophy Degree

University of Missouri-Kansas City, 2012

ABSTRACT

African Americans are disproportionately burdened by sexually transmitted infections
and human immunodeficiency virus in the US. The current study examined relationships
between demographics, religiosity, ethnic identity, and sexual risk behaviors among 202
sexually active African American church-affiliated participants (mean age = 25; 69%
female). Participants were fairly religious as evidenced by their reports of weekly
engagement of scripture reading and daily engagement in thoughts of God and prayer.
Participants spent quite a bit to a great deal of time utilizing positive religious coping and
little to no time utilizing negative religious coping. In addition, participant’s God control
beliefs moderately influenced their choices related to engagement in sex. Participants
reported moderate levels of ethnic identity exploration and commitment. On average,
participants reported 10 lifetime sex partners and two within the past six months. Age was
significantly predictive of lifetime sexual checklist factors (i.e., having sex while high on
drugs or alcohol, being a victim of domestic violence, having sex with someone who has
been in the correctional system) and previous six month and lifetime sex-only factors (i.e.,
number of sex partners, condom use). None of the primary study predictors (i.e., religious
beliefs and behaviors, religious coping, God control beliefs, ethnic identity) were
significantly associated with risky sexual behaviors.
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APPROVAL PAGE
The faculty listed below, appointed by the Dean of the College of Arts and Sciences, have
examined the dissertation titled, “Religiosity, Ethnic Identity, and Risky Sexual Behavior in
an African American Church-Affiliated Population,” presented by Starlyn M. Hawes,
candidate for the Doctor of Philosophy degree, and hereby certify that in their opinion it is
worthy of acceptance.
Supervisory Committee

Jannette Berkley-Patton, Ph.D., Committee Chair
Department of Psychology

Kathleen Goggin, Ph.D.
Department of Psychology

Delwyn Catley, Ph.D.
Department of Psychology

Kymberley Bennett, Ph.D.
Department of Psychology

Vanessa Malcarne, Ph.D.
Department of Psychology

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CONTENTS

ABSTRACT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii

LIST OF TABLES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vi

Chapter

1. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .1

2. SCOPE OF THE PROBLEM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Chlamydia in African American and Caucasian Adults . . . . . . . . . . . . . . . . . . . . . . . . . 7

Gonorrhea in African American and Caucasian Adults . . . . . . . . . . . . . . . . . . . . . . . . . 7

HIV in African American Adults . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Local STI/HIV Prevalence among African American Adults . . . . . . . . . . . . . . . . . . . . 8

3. SEXUAL RISK BEHAVIORS AMONG AFRICAN AMERICAN ADULTS . . . . . . . . 10

Individual Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Social Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Environmental Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

4. REVIEW OF RELIGIOSITY LITERATURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Religiosity in the General Population and its Relationship to Health. . . . . . . . . . . . . . . 16
Religiosity in the African American Community and its Relationship to Health . . . . . 18
Religiosity and Sexual Risk Behaviors Among African American Church Populations 23
5. REVIEW OF ETHNIC IDENTITY LITERATURE . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Ethnic Identity and Religiosity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Ethnic Identity and Risky Sexual Behaviors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
6. METHODOLOGY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

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Participants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40

7. ANALYSIS PLAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

8. RESULTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Assessing reliability and validity of Primary Predictor Measures . . . . . . . . . . . . . . . . . .49

Descriptive Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

Bivariate Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

9. DISCUSSION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

Implications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

APPENDIX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71

REFERENCES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90

VITA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98

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TABLES

Table Page

1. Summary of Indices for each Hypothesized Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

2. Demographic Variable Descriptives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72

3. Religious Beliefs and Behaviors (RBB) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74

4. Religious Coping (Brief RCOPE) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

5. Sex God Locus of Control-Adolescent (SexGLOC-A) . . . . . . . . . . . . . . . . . . . . . . . . . . 76

6. Multiethnic Identity Measure-Revised (MEIM-R) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

7. Lifetime HIV Behavioral Risk Assessment Checklist (BRAT-checklist) . . . . . . . . . . . . .78

8. HIV Behavioral Risk Assessment Sex Only (BRAT-sex only) . . . . . . . . . . . . . . . . . . . . .79

9. Marlowe-Crowne Social Desirability Scale 1 (M-C1) . . . . . . . . . . . . . . . . . . . . . . . . . . . .80

10. Correlations Among Demographic Predictors, M-C 1, and BRAT Components . . . . . . 81

11. Regression of BRAT-Checklist on Significant Demographic Correlates (Model 1) . . . .82

12. Regression of BRAT-Sex Only for the Past Six Months on Significant Demographic

Correlates (Model 2) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83

13. Regression of Lifetime BRAT-Sex Only on Significant Demographic Correlates (Model

3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84

14. Correlations Among Primary Predictors, M-C 1, and BRAT Components . . . . . . . . . . 85

15. Correlations Among Primary Predictor Subscales, and M-C 1, BRAT Components . . .86

16. Regression of BRAT-Checklist on Primary Predictor Interaction Terms (Model 4) . . . 87

17. Regression of BRAT-Sex Only for the Past Six Months on Primary Predictor Interaction

Terms (Model 5) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88

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18. Regression of Lifetime BRAT-Sex Only on Primary Predictor Interaction Terms (Model

6) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89

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CHAPTER 1

INTRODUCTION

Sexually transmitted infections (STIs) and human immunodeficiency virus (HIV) in
African American communities continue to be a major public health problem. While African
Americans make up only 13% of the US population, they incur approximately 55% of STIs
and account for approximately 49% of HIV cases (CDC, 2009; US Census Bureau, 2010). In
2009, chlamydia rates were 8 and 12 times higher among African American women and men,
respectively, than Caucasian women and men. Gonorrhea rates were 17 and 26 times higher
among African American women and men, respectively, than Caucasian women and men.
Furthermore, HIV rates were 18 and 6 times higher among African American women and
men, respectively, than Caucasian women and men (CDC, 2009). As infection rates continue
to rise in underserved communities, more research is needed to identify protective factors
that contribute to resiliency against STIs and HIV among African Americans.
Several individual, social, and environmental factors exist that put African Americans
at risk for STIs/HIV. Individual and social factors include having unprotected sex with a
partner who is considered to be at high risk for HIV transmission (Laumann & Youm, 1999),
being unaware of sex partners’ STI/HIV status, having other existing STIs, and living in
poverty (CDC, 2007). Other individual and social factors include, but are not limited to,
inconsistent condom use, drug and alcohol use, several lifetime partners (Corneille,
Zyniewski, & Belgrave, 2008; Cornelius, Okundaye, & Manning, 2000), and lack of
disclosure of bisexuality -- or “being on the down low” (McNair & Prather, 2004).
Environmental factors are primarily associated with low-income communities and include
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lack of access to health care (Elifson, Klein, & Sterk, 2003), unstable housing or
homelessness, limited access to HIV prevention education, and high density of STI and HIV
infections in many communities of color (Barrow, Newman, Douglas, 2008; McNair &
Prather, 2004).
Although there are a number of common STI/HIV risk factors for the African
American community as a whole, men and women of this ethnicity are differentially
impacted by risk factors. For African American men, the most common HIV transmission
routes include unprotected sex with a man, injection drug use (IDU), and unprotected sex
with a woman (CDC, 2009). For example, 51% of new HIV cases among African American
men were attributed to men who have sex with men and 21% were attributed to IDU in 2008.
For African American women, the most common HIV transmission routes are engagement in
unprotected heterosexual sex and IDU, which attribute to 75% and 24% of new cases among
AA women, respectively (CDC, 2009). High rates of STIs among African American women
might also contribute to their disproportionate HIV case rates compared to Caucasian
women. In 2008, reported cases of gonorrhea and chlamydia among African American
women were approximately 8 and 17 times higher, respectively, than for Caucasian women
(CDC, 2009). Studies have shown that the presence of gonorrhea and chlamydia in women
increases the facilitation of HIV infection during sex with an infected male partner (Fleming
& Wasserheit, 1999).
Conversely, a global protective factor that has been identified as being inversely
related to sexual risk behaviors in the African American community is religiosity. While
some studies have found mixed results (e.g., Jarama, Belgrave, Bradford, Young, &
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