Discrimination and Sexual Risk Among Young Urban Pregnant Women of Color
By Lia Valenzuela
What do we already know?
Young Black and Latina women are at risk of HIV and other STIs in the United States:
- Those who are socioeconomically disadvantaged, such as Black and Latino Americans, experience a disproportionate burden of HIV and other STIs.
- In the US, young women have the highest rates of STIs.
- The percentage of people living with HIV/AIDS who are women has steadily increased over the past two decades among 15-24-year-olds.
Discrimination has been identified as a key factor associated with increased risk for many negative health outcomes. This helps to explain multiple racial and socioeconomic health inequities, and may play a role in health inequities related to HIV/STIs.
What do we want to find out?
Drs. Rosenthal, Earnshaw and their colleagues tested the association that discrimination has with condom use, risky sexual partners, and self-reported sexually transmitted infection (STI) diagnosis among a sample of young, socioeconomically disadvantaged, Black and Latina women during the second and third trimesters of pregnancy. Inclusion criteria were pregnancy less than 24 weeks gestation, no medical problems indicating high-risk pregnancy (e.g., HIV positive), ability to speak English or Spanish, and willingness to participate in study procedures. There were a total of 1,240 women who enrolled in the study. Of that, 841 women were included in the analyses for any unprotected sex, 873 were included for any risky partners and 885 were included for any STI diagnosis because they completed all of the needed survey questions.
What did they find?
A mean discrimination score was created, with higher scores indicating more frequent experiences with discrimination. Participants also reported what they perceived to be the main reason for these experiences, including race/ethnicity, gender, age, income level, language, physical appearance, sexual orientation or other.
- Participants’ experiences of everyday discrimination during the second trimester significantly predicted greater odds of having any risky partner and having been diagnosed with an STI during the third trimester. Everyday discrimination during the second trimester was the only significant predictor of having had a new STI diagnosis during the third trimester. However, everyday discrimination did not significantly predict having any unprotected sex.
Discrimination has been identified as a vital predictor of important health outcomes. It is also important in understanding what causes large and persistent health disparities in the U.S. This was the first investigation to find that discrimination experienced by young, predominantly Black and Latina, urban pregnant women is associated with increased odds of having risky partners and contracting an STI. Now that we have obtained this information, we can help work together to help reduce discrimination and attempt to reduce the negative health outcomes associated with it.
Reference: Rosenthal, L., Earnshaw, V. A., Lewis, J. B., Lewis, T. T., Reid, A. E., Stasko, E. C., Tobin, J. N., & Ickovics, J. R. (2014). Discrimination and sexual risk among young urban pregnant women of color. Health Psychology, 33(1), 3-10. PMC3951106