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HIV-related sexual decisions made by African-American adolescents living in different family structures: study from an ecodevelopmental perspective

Authors Li YH, Cuccaro P, Chen H, Abughosh S, Mehta PD, Essien EJ

Received 22 June 2017

Accepted for publication 17 January 2018

Published 9 March 2018 Volume 2018:10 Pages 19—31

DOI https://doi.org/10.2147/HIV.S144594

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Professor Bassel Sawaya


Ya-Huei Li,1 Paula Cuccaro,2 Hua Chen,1 Susan Abughosh,1 Paras D Mehta,3 Ekere J Essien1,2

1Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Texas Medical Center, Houston, TX, USA; 2Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, TX, USA; 3Department of Industrial Organizational Psychology, University of Houston, Houston, TX, USA

Purpose: The purpose of this study was to explore the association between the dynamics of family structure and sexual behaviors of African-American adolescents using the ecodevelopmental theory.
Methods: This study stratified data from 1,617 African-American adolescents of the Add Health Wave I respondents with an identified family composition. It examined the associations between family structure, parenting function, and adolescents’ sexual decision-making: age of first sexual intercourse, sexual initiation before age 16, and using a condom during the first and last sexual intercourse.
Results: Emotional connection between parents and children (feeling more love from the father: β=0.17, P=0.0312; feeling more love from the mother: β=0.3314, P=0.0420) and mothers’ less permissive attitude toward adolescents’ sexual experience in their teens (β=0.33, P=0.0466) are positively associated with late age of sexual initiation of adolescents living in two-parent households. School-level factors (β=0.07, P=0.0008) and the adolescents’ characteristics (being older: 0.42, P=0.0002; heterosexuality: β=2.28, P=0.0091) are the factors most positively related to the age of sexual initiation for those living with a single parent. Immediate social determinants, other than family factors (such as land use of immediate area [rural]: β=9.84, P<0.0001; the condition of living unit: β=1.55, P=0.0011; and safety of neighborhood: β=4.46, P=0.004), are related to late age of sexual initiation among those living with other relatives/alone. A higher tendency of condom use consistency was present in adolescents living with two parents compared to those living in other family structures.
Conclusion: Less parent/child connection and parent/family influence were found in African-American adolescents living with other relatives or alone, suggesting that living with two residential parents plays an essential role in their late sexual initiation and could account for an important element to combat high HIV incidence of African-American adolescents.

Keywords: ecodevelopmental theory, African-Americans, adolescents, family structure, parenting function, sexual behaviors
 

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