Challenge, Vol. 13, No. 2
Intersection Between Race, Gender, and Sexual Risk:
Implications for STI/HIV on HBCU Campuses
____________________________________________________
Sinead N. Younge,1
Deidre Smith,2
Lawrence Young,1
Daphne Cole,2
Danielle Dickens,2
Lauren Reynolds,2
Raqiyah Dixon,2
Wilton Robinson,1
Porsche N. Buchanan,2
_________________________________________________________
Abstract
There is a disproportionate incidence and prevalence rate of
Human Immunodeficiency Virus (HIV) among African Americans.
HIV/AIDS is one of the leading cause of death among Blacks,
aged 25-44. It is likely that many of these individuals contracted
HIV while they were college aged. Black college students are an
understudied group. The behaviors of college students in general,
and the combination of environment and individual behaviors,
warrants further investigation of sexual risk behaviors among Black
college students. Furthermore, it is important to understand both
the risk and protective factors that different environments may
play. A substantial number of Black students attend Historically
Black Colleges and Universities (HBCUs), which have purported
to have protective affects on risk behaviors. This paper will give a
cursory review of the sexual risk literature of Black college students
and identify some of the risk and protective factors associated with
HBCUs.
________________________________________
1 Department of Psychology, Morehouse College
2 Departments of Psychology and History, Spelman College
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Introduction
While African Americans comprise approximately 13% of
the U.S. population, they have higher incidence and prevalence rates
of acute and chronic diseases, and overall poorer health outcomes in
comparison with other racial groups. Nowhere are these disparities
more evident than in the HIV/AIDS epidemic. Identified by the
Centers for Disease Control and Prevention (CDC) in 1981, the
human immunodeficiency virus (HIV) emerged in U.S. metropolitan
cities among large numbers of homosexual males or men who have
sex with men (MSM) and intravenous drug users (IDUs). These
early cases led individuals to believe that HIV, which was originally
coined as gay related immunodeficiency disease (GRID), mostly
affected gay White males.
Much of the early prevention efforts targeted the gay
community and despite CDC data suggesting that Blacks1 may be at
an increased risk for the disease as early as 1982, African Americans
did not become a high priority group for prevention efforts until the
1990s. This early lack of focus and prevention efforts on communities
of color may have indirectly influenced the increasing HIV incidence
and prevalence rates among people of color and specifically, African
Americans, while the rates of other groups began to decline or
stabilize (CDC, 2007). Once Blacks became a high priority group for
research and surveillance, the majority of research focused on low-
income, urban, or intravenous drug using populations despite the
fact that the risk behaviors of other segments of the Black population
(i.e., college students) placed them at increased risk for sexually
transmitted infections (STIs) including HIV, and it is likely that a
substantial proportion of African Americans contracted HIV while
in college (Ferguson, Quinn, Eng, Sandelowski, 2006). This paper
will: (1) provide a cursory overview of the current literature on the
understudied Black college student population, (2) the unique
___________________________________________
1 For the purposes of this paper, the labels African Americans and Blacks will be
used interchangeably.
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influence that HBCUs can have on risk and protective factors, and (3)
examine how previously identified factors such as gender, race, and
sexual risk intersect to play a role in the behaviors of Black college
students.
Blacks and HIV/AIDS
In 1992, 11 years after the CDC’s identification of HIV, Blacks
were 3.5 times more likely to contract AIDS than Whites and Black
women were 13.8 times more likely to contract AIDS than White
women (Jenkins et al. 1993). Eighteen years later in 2005, Blacks
accounted for 49% of the new HIV/AIDS diagnoses (CDC, 2007).
In 2005, Blacks were 10 times more likely than Whites to have an
AIDS diagnosis and Black women were 23 times more likely than
their White counterparts to have an AIDS diagnosis. Among Blacks,
men who have sex with men remain the primary risk group for HIV
followed by IDUs, and high risk heterosexuals (CDC, 2007). As of
2002, HIV was the second leading cause of death for individuals aged
25 to 44 (CDC, 2007). The majority of these individuals probably
contracted HIV when they were college age.
Moving Beyond the Biomedical Framework
Researchers have speculated about the multiplicity of risk
factors that place Blacks at increased risk for HIV. Diverging from
the biomedical model, the CDC reports that race and ethnicity
alone are not risk factors for HIV infection. The second generation
of HIV/AIDS research examines sexual risk behavior from an
ecological perspective, examining how individuals interact with their
environments and the resulting behaviors. Increased susceptibility
to HIV is a function of behaviors, environment, and predisposing
physiological conditions such as the existence of ulcerative and non-
ulcerative STIs that make individuals biologically more susceptible to
contracting HIV by compromising the mucosal barrier that normally
protects against infection (Berman & Cohen, 2006; Clan, 2006).
Despite comparable or higher rates of condom use reported between
Blacks and Whites, Blacks remain more likely than Whites to have
an STI which increases one’s chance 3 or 5 fold of contracting HIV
(CDC, 2007; Quinn, 1996). This finding of similar rates of condom
use among some Blacks and Whites, but higher rates of STIs among
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Blacks is purported to result from other social and economic factors.
For instance, Blacks have historically had less access to healthcare
including early diagnosis and treatment of STIs, mistrust of the
medical establishment, higher rates of intravenous drug use, higher
rates of incarceration, and a male-female sex ratio imbalance which
may result in serial monogamy, or shared partner networks, power
imbalances in relationships, homophobia, and risky social norms
(Ferguson et al., 2006). Combined, all of these factors place Blacks
at higher risk than their White counterparts for contracting an STI/
HIV.
The majority of early research on Blacks and HIV has
examined the proximal determinants of HIV and has taken a deficit
perspective, focusing on the individual risk behaviors. Individual
risk factors alone, to not explicate the disparate rates of HIV among
the various racial and ethnic groups. As previously mentioned, there
are a number of environmental or contextual factors to take into
account. Additionally, there are inherent strengths within the Black
community that can act as protective factors against sexual risk.
Discourse on HIV is incomplete without an examination of both the
risk and protective factors that influence sexual behavior.
Black College Students
Black college students represent only one segment of the
heterogeneous Black population. Research on Black college students
can provide invaluable information about the 14% of African
Americans over the age of 25, who hold a B.A. degree (U.S. Bureau
of the Census, 2003). HBCUs enroll 13% to 14% of all Black students
in higher education in the U.S., although they constitute only three
percent of America’s institutions of higher education. In 2001, more
than one-fifth of all bachelor’s degrees awarded to Blacks were from
HBCUs (Provasnik & Shafer, 2008). Despite the high risk behaviors
of college students in general, Black college students remain an
underrepresented and understudied group. Blacks are often indirectly
studied in small sample sizes as part of larger studies of the general
college population at predominately White institutions (PWIs). When
Blacks are the sole focus of a study, the risk and protective factors of
these community and clinical (often low-income or IDU samples),
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may not be generalizable to the experiences of other segments of
the Black community (i.e., college educated samples). Although
extensive epidemiogical studies of the general college population
are lacking, one early study speculated that the rate of HIV among
college students is 2 per 1,000 students and are purported to be
even higher among Black college students (Gayle, Keeling, Garcia-
Tunnon, Kilbourne, Narkunas, Ingram et al., 1990).
Adolescents and Risky Behaviors
The 2005 national survey of 9th through 12th grade U.S.
public and private school students known as the National Youth
Risk Behavior Surveillance (YRBS). Study reported that Black high
school students were more likely to report having ever had sexual
intercourse, having sexual intercourse before the age of 13, having
more lifetime partners, being currently sexually active, and less likely
to report using a condom the last time they had sex in comparison
with their White counterparts. However, Black students were less
likely to report using a number of illicit substances and having
had an episode of heavy drinking, than their White counterparts
(YRBS, 2006). These risk behaviors often carry over to the college
years. It is estimated that greater than 80% of all college students
are sexually active by their freshmen year, and less than half use
condoms consistently (Fisher, Spurlock-McLendon, DelGado, &
Melchreit, 1999; Lewis, Malow, & Ireland, 1997). Previous studies
suggest that college students in general, consistently engage in high-
risk behaviors including inconsistent condom use, illicit substance
and alcohol use during sex, and sex with multiple partners (Hightow,
Leone, MacDonald et al., 2006).
HBCUs in the Forefront
The current interest in HBCUs and their roles in the HIV
epidemic was stimulated in 2003 when the CDC published a report
entitled “HIV Transmission Among Black College Student and
Non-Student Men Who Have Sex With Men.” Based on the findings
from this retrospective study conducted by the North Carolina
Department of Health with the assistance of the CDC, researchers
and the general population began to speculate about the role that
men who have sex with men (MSM) played as vectors in the HIV
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epidemic among African American women. The discussion over
MSM became even more publicized in the popular media with the
2004 release of J.L. King’s book, “On the Down Low: A Journey
into the Lives of “Straight” Black Men Who Sleep with Men.” The
term downlow has been in existence in the Black community for a
number of years, but it is currently used to describe the behavior of
men who have sex with other men as well as women (MSM/W) and
do not identify as gay or bisexual. While some women have been
infected through intercourse with bisexual men, there is simply not
enough empirical evidence to confirm this claim as a major route
of transmission (CDC, 2007). Despite the misguided efforts of the
mainstream media to assist Black women in identifying or revealing
non-identified MSM/W as the main scapegoats in the contemporary
HIV/AIDS epidemic in the Black community, Black MSM continue
to have the highest risk for contracting HIV of all groups, and there
remains a lack of understanding of this “difficult to reach” and often
misunderstood group.
Black men who have sex with men
The White gay community has effectively mobilized and
organized HIV education and prevention efforts to reduce HIV
incidence rates. In contrast, the Black gay community is not as
visible and cohesive. Hence there is a significant proportion of
Black MSM who, due to racial, cultural, or religious reasons, do not
embrace a “gay identity.” Racism, cultural beliefs about masculinity,
sexual orientation, and religious doctrine (which often condemns
homosexual behavior) decrease the desire to take on the label of
“gay.” Therefore, researchers have focused on the behavior of ‘men
who have sex with men,’ rather than the identity of being gay.
With the advent of the internet including chat rooms
and networking sites, Black MSM may find it easier and more
comfortable to meet and interact with other MSM with a certain level
of anonymity and confidentiality. Consequently, the internet also
exposes individuals to a high number of potential sex partners with
various HIV risk statuses. This perceived anonymity may sometimes
cause individuals to engage in riskier behaviors-behaviors in which
they would not typically engage. Consequently, the internet becomes
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a new frontier for researchers to recruit and understand sexual risk
behaviors under different social networks.
Individuals are often first exposed to vastly new social
networks during their college years. Coincidently, college becomes
a time when individuals of all sexual orientations may attempt to
exercise their new independence and autonomy and engage in
sexual exploration and experimentation and/or practice safer sexual
behaviors including abstinence, monogamy, and consistent condom
use (Foreman, 2003).
Black Heterosexual Males
An area of research that is receiving an increasing amount
of attention is heterosexual African American male behavior.
Researchers have long claimed that men are likely to be more casual
than women in their sexual behaviors and to engage in greater
sexual risk taking (Poppen, 1995). However, research indicates that
gendered sexual risk difference is complicated and context specific.
There are a number of sociocultural factors that influence the sexual
risk behaviors of Black heterosexual males.
Traditional gender roles dictate that men be the initiators of
sexual activity and many of the HIV prevention campaigns that target
women, hold this supposition. However, there is evidence that men
will engage in unwanted sexual activities because of their partner’s
tactics (Russell & Oswald, 2002; Struckman-Johnson, 1988). The
types of sexual coercion by women may differ than the type of male
initiated sexual coercion. Interestingly, some studies estimate that
up to 44% of male college students reported being the recipient of
a sexually coercive tactic (Russell & Oswald, 2002). Moreover, male
initiated sexual coercion tactics are more likely to be viewed as
threatening or capable of doing harm than women initiated sexually
coercive tactics which may be viewed as promiscuous (Oswald &
Russell, 2006). Unlike males who may be more likely to use alcohol,
verbal, or physical strategies, women are more likely to use verbal
tactics. Black males who are sexually coerced by women may have
their masculinity questioned, and feel the need to have to prove their
manhood through sexual acts, although more research in this area is
needed to support this assertion.
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Despite engaging in high-risk activities, college students
(including Black college students) have a low subjective perception
of HIV risk (Payne, 2006). In a qualitative study conducted by
Thompson-Robinson and colleagues (2007) of the perceptions
of heterosexual (N=57) African American males’ high risk sexual
behaviors, participants reported partner attractiveness, being in
love, sensation seeking, substance use, knowing that another man
had sex with a woman and did not contract a disease, and physical
arousal as some reasons why heterosexual African American males
may engage in unprotected sexual intercourse. When asked about
cultural influences on African American males’ sexual behaviors
and practices, the participants reported that their friends and
acquaintances, media, and spirituality all influenced sexual behavior.
While religious doctrine was reported as influencing sexual decisions
and behaviors, concerns regarding pregnancy and acquiring HIV
or other STIs also acted as deterrents to risky behaviors. In a 2003,
qualitative study of Black college women (n=15), similar findings
as those of Thompson-Robinson and colleagues, were reported.
Participants reported sensation seeking or pleasing their partners as
a primary reason for not using condoms.
In a longitudinal, within group, cluster analysis of the
heterogeneity patterns of sexual risk behaviors among African
American youth, Burrow and colleagues (2007) found that patterns
of sexual risk were related to lifetime psychiatric diagnoses, which is
consistent with previous research in this age group (Shrier, Harris,
Kurland, & Knight, 2003). African American are overrepresented in at
risk populations that are susceptible for compromised mental health
due to economics, incarceration, foster care, exposure to violence,
access to health care (SAMHSA, 2008) therefore, prevention efforts
need to target these groups specifically.
Black Heterosexual Women
The HIV epidemic does not uniformly affect African
American women. Instead, the increasing incidence rates are most
commonly found among women of lower socioeconomic statuses
and hence most of the research has focused on this group. Few studies
have examined the risk factors of African American women college
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students. One sociocultural factor that transcends social strata is
interpersonal power. Interpersonal power has demonstrated to be
necessary to engage in HIV protective behaviors within the context of
dyadic relationships and there exist a number of cultural factors that
are hypothesized to intersect and predict interpersonal relationship
power in relationships that are generalizable to all women.
Wingood and DiClemente’s (1998) Expanded Theory
of Gender and Power (TGP) explains how interpersonal power
influences HIV protective behavior among African American
women, while taking into account the intersection of culture, gender
relations, and various traditional cognitive behavioral factors.
Namely, among Black college students, these power imbalances may
be less influenced by threats of violence, gender and peer norms,
perceived sex ratio-imbalance, and the desire to be in a relationship,
also known as the structure of Cathexis in TGP. Foreman (2003)
found that Black college women would rather relinquish their power
to engage in safer sex and give in to their own or a partner’s needs
or desire, than engage safer sexual behavior. In Foreman’s study,
participants reported that their longing for intimacy and desire for
a long-term relationship overshadowed or even compromised their
risk reduction (e.g., condom negotiation) capabilities (Fullilove,
Fullilove, Haynes, & Gross, 1990). This compliance with partners’
actual or perceived preferences may be a result of the gender ratio
imbalance articulated early in the HIV epidemic by Mays and
Cochran (1988) and Fullilove and colleagues (1990).
The gender ratio imbalance among Blacks exists in the
general society and particularly among Black college students, with
Black females outnumbering Black males for the last several decades.
The actual and perceived gender ratio imbalance, is purported to
result in men having multiple sexual partners and women having to
decide whether or not to accept this and perhaps knowingly engage
in the act of man sharing (Fergueson et al., 2006). An additional
consequence of the gendered sex ratio imbalance may be women
who engage in serial monogamy in hopes of securing an intimate
relationship while increasing their number of lifetime sexual partners,
and in turn increasing their risk of contracting an STI. Subsequently,
African American college women have reported being more likely to
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engage in risky sexual behaviors such as condom non or inconsistent
use, when they were in a committed romantic, sexual relationship
(Winfield & Whaley, 2005).
Gender Roles
Another influential social construct is gender roles which
set up different sexual expectations for men and women. While
biological gender differences transcend race, class, and sexual
orientation, gender roles are socially constructed and may vary
depending on cultural norms. In general, gender roles dictate that
men initiate sexual activity and women are suppose to resist or limit
sexual activity and be more concerned with romance and affection
than sex (Peplau & Gordan, 1985). Although children are socialized
to various gender role norms and expectations based on their cultural
mores, the college years are a time of exploration during which ideas
about gender are particularly salient and may shift according to the
environment. College students may be exposed to mainstream and
more common stereotypes in new domains such as generalizations
about masculinity and femininity in dating relationships.
Traditionally defined gender roles within the confines of a
relationship can have a significant impact on how individuals engage
in sexual encounters. Traditional gender roles can influence sexual
coercion or intimidation, which has been identified as a serious issue
on college campuses (Owald, 2005). Though much of the initial
research focused on men as the aggressor, recently, researchers have
begun to acknowledge that women also behave in a coercive manner
in their sexual encounters (Oswald & Russell, 2005). There is evidence
that people judge men and women differently when they engage in the
same aggressive behaviors (Oswald & Russell, 2005). Subsequently,
there is a double standard in how individuals of different genders are
perceived. Women who are sexually assertive or who carry condoms
may be viewed as promiscuous. Conversely, men who refrain from
sex or are not assertive may have their masculinity questioned. In a
recent study conducted by Shearer (2005), the more men endorsed
the idea that men should not behave in a feminine manner, the
greater their likelihood of engaging in risky sexual behavior.
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Substance Use
In addition to the psychosociocultural factors that influence
sexual risk behaviors, there are salient biological factors that place
African American youth at increased risk. There is a well established
behavioral and biological link between sexual risk behaviors and
substance use including alcohol and other drugs (AOD). Individuals
who abuse alcohol and other substances have demonstrated to be at
increased risk for STIs including HIV (CDC, 2007). This relationship
between substance use and increased risk for STIs can be caused by
using substances which impair decision making, and/or comprising
immune system functioning and in turn, cause individuals to be
more susceptible for contracting an infection.
As previously noted, college is often a time of sexual
exploration, and exploration/ experimentation with various
substance. The aforementioned 2005 YRBS also examined substance
use behavior in a national survey of 9th through 12th graders. Black
students reported lower rates of cigarette smoking, lifetime and
current prevalence of alcohol use, and all other illicit substances in
comparison with their White counterparts (YRBS, 2006). Studies
confirm that students at HBCUs and African American students in
general drink substantially less and suffer fewer consequences than
do students at predominantly White institutions (PWI). Researchers
purport that the disparity in alcohol consumption appears to
be strongly related to protective factors such as HBCUs’ general
emphasis on character development in their institutional missions
and possibly, their enrollment of many students with strong religious
values and their own religious foundations (Kapner, 2003). The
environment at HBCUs may mitigate against the “culture of drinking”
and other substance use found on many PWI campuses (Kapner,
2003). However, evidence suggests that Black students who attend
PWI, also have lower rates of substance use in comparison with their
White counterparts therefore, the protective factors may exist prior
to entering college and be reinforced on HBCU campuses.
In a 2003 study of marijuana use at two HBCUs, Bowen-
Reid and Rhodes found that 52% of their sample reported at least
one instance of lifetime marijuana use. Twenty five percent of their
sample reported starting to smoke between the ages of 15 to 17,
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while 16% of their sample reported starting to smoke marijuana
in college. Approximately 6.5% of the sample reported smoking
marijuana daily. Gender differences also exist, males were more likely
than females to smoke marijuana. The findings from this study also
demonstrated that lower rates of marijuana use were related to higher
levels of spirituality. Therefore, as previously noted, spirituality has
demonstrated to be a protective factor against risky sexual behavior
and substance use. Researchers are increasingly interested in the role
of protective or factors that buffer against adverse health behaviors.
If identified, these factors can be instrumental in developing effective
prevention interventions. Among a number of identified protective
factors are the family, social support, and spirituality and religiosity.
Role of the Family
Parents play a critical role in shaping their children’s
behaviors. “Generally, the role of the family is to act as the primary
socialization agent and provide support and codes of conduct for
social competence for children within a given network” (Younge &
McAdoo, in press). Traditionally, Blacks adhere to a communalistic or
collectivist worldview and the Black family has been identified as one
of the most enduring strengths in the resiliency of Blacks (McAdoo,
1992). Additionally, the Black family has been purported to act as
a buffer or protective factor against “menacing societal stimuli”
(Hayles, Bell, Evans, Floyd, Monteiro, Daniels & Harrell, 2004, p.
410). Previous research demonstrates that parents exert more power
on the behavior of adolescents, than previously thought (Hutchinson
& Montgomery, 2007). Parental factors that influence risk behaviors
include parent-teen closeness, social support, parental monitoring,
parental expectations, and parent-child communication (Jaccard,
Dittus, & Gordan, 1996; DiClemente, Wingood, Crosby, Cobb,
Harrington, Davies, Hook, & Oh, 2001; Li, Feigelman, & Stanton,
2000; Miller et al., 1999; DiLorio, Kelly, & Hockenberry-Eaton, 1999;
Dutra, Miller, & Forehand, 1999, St. Lawrence, Brasfield, & Jefferson,
1994).
Some studies have shown that children will refrain from
certain risky behaviors (e.g., substance use) for fear of disappointing
their family and communities (Jordan, 2001). Black parents often
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encourage their children to surpass the achievements of previous
generation and children are commonly informed of the sacrifices
made by their parents and prior generations. These expectations
can enhance an investment in future orientation. Constructs such
as future orientation or ‘planning for tomorrow,’ has demonstrated
to positively predict African American college women’s condom
frequency. “Using condoms in the present provides an individual
with a safeguard against possible negative future consequences
associated with failure to use condoms consistently during sexual
activity” (Burns & Dillon 2005:184).
Previous research has demonstrated that parental monitoring
plays a critical role in the decrease of risky sexual behavior among
adolescents (DiClemente et al., 2001). As individuals transition to
college, parental monitoring becomes inconsequential and “social
ties to family and other social institutions that promote conventional
norms” (Voisin et al., 2006, p. 72) may act as a buffer for risky sexual
behaviors. Another study examined parental influences on the
sexual risk attitudes, beliefs, and behaviors of African American,
late adolescent HBCU students (Hutchinson & Montgomery, 2007).
The results demonstrated that female students had a greater amount
of parent-teen sexual risk communication with their mothers, in
comparison with male students. As expected, male students reported
greater parent-teen sexual risk communication with their fathers
in comparison with female students yet there were no significant
differences between males and females in the total amount of
communication from parents. Students who reported higher levels
of communication also reported feeling closer to their parents
during their high school years, and a greater perceived importance
of their parent’s opinions. This research indicates that an increase in
mother sexual communication is associated with more conservative
attitudes towards sex by students and less difficulty discussing sexual
topics with their partners. Greater communication with fathers has
also been associated with more positive attitudes toward condom
use among female students and less difficulty discussing condoms
among male students.
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Media Influences
In addition to parents, the media is influential in framing
individuals’ (particularly adolescents) perceptions and images
about how relationships should and do function. Relatively little
research has examined whether exposure to sex in the media has a
long-term impact on teens’ sexual behavior. In a recent longitudinal
study conducted by Brown and colleagues (2006), researchers
assessed whether early Black and White adolescents (aged 12 to
14) who have more exposure to media were more likely than those
with less exposure to media to have more advanced precoital and
coital behavior by middle adolescence? Their findings indicated
that younger adolescents with the highest exposure to sexual media,
were 2.2 times more likely than older adolescents to have had sexual
intercourse. In their study, Black adolescents’ sexual activity was more
likely to be influenced by parental expectations and peer behavior,
than media influences. This is consistent with the aforementioned
influence of the Black family.
Currently, one of the most popular and influential
entertainment mediums is hip-hop or rap music. Although hip
hop has gone through several major iterations, the latest ongoing
debate regarding its depiction of African American lifestyles
remains controversial. Most recently, the misogynist portrayal of
women in some music videos, television shows, and movies has
been publicized and criticized. One of the major concerns of most
critiques is the youth who are influenced by certain propaganda
and ascribe to the stereotypical roles being portrayed. Thompson-
Robinson and colleagues found that the media had an impact on
the sexual behaviors and perceptions of HIV risk among their Black
male, college participants. One male participant reported that the
images of females in the music videos had an ”impact on one’s
psyche” and if a rap artist was not having sex with all of the women
in their [videos], they were “less of a man” (Thompson-Robinson et
al., 2007, p. 162). The use of certain aspects, such as sex, fame, and
glamorization of the hip-hop culture is used as a medium to promote
the sale of products and lifestyles. The inability of some young people
to discern entertainment from reality becomes even more troubling
and results in the emulation by both men and women, to behave
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in a manner which is consistent with certain aspects of some hip
hop artists (i.e., the objectification of women as being hyper sexual,
and men as abusive, the glamorization of casual sex, promiscuity,
substance use), with little attention to consequences such as the
acquisition of STIs. Another study of African American female
adolescents sought to determine whether perceiving portrayals of
sexual stereotypes in rap music videos was associated with adverse
health outcomes including substance use and sexual risk behaviors
(Peterson, Wingood, DiClemente, Harrington, & Davies, 2007).
Peterson and colleagues demonstrated a relationship between
increased perception of sexual stereotypes and binge drinking,
marijuana use, multiple sexual partners, and negative body image.
It appears that exposure to rap videos had a negative impact on the
health behaviors of African American adolescent girls. However,
these findings must be cautiously interpreted and it must be noted
that this study can not determine the direction of the relationship
such that does rap have an affect on health, or does one’s sexual
behavior influence how they perceive rap music? Given the current
age of technology, it is apparent that the media’s influence health
behavior warrants further investigation.
Conclusion
In accordance with the recognition that individual level,
proximal factors such as beliefs, knowledge, attitudes, and behaviors
alone do not sufficiently explain the disproportionate burden
of HIV/AIDS on African Americans, researchers have begun to
look to environmental or contextual factors. Additionally, rather
than overwhelmingly focusing on specific segments of the Black
population (e.g., low income, substance users, MSM), researchers
are currently expanding their investigations to other segments of the
Black population including college students. This focus on college
students despite, little epidemiological data on their actual HIV rates
is supported by the fact that many African Americans were infected
while they were college age.
Application of an ecological model of health behaviors
would lead to the examination of different environments for college
students and the risk and protective factors associated with those
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students and their environments. Differences in disease rates have
demonstrated to be influenced by the differential distribution of
risk behaviors including, smaller partner pools (e.g., small vs. large
student populations), and risk behaviors (e.g., low vs. high substance
use, IDU use versus alcohol or marijuana use). These differences
influence the higher rates of STIs and HIV in certain populations,
but also indicate that certain aspects of the HBCU environment may
contain certain risk and protective factors against sexual risk. The
college experiences of Black students vary by the type of institution
they attend. Research has demonstrated that there is a distinction
between Black students enrolled in predominantly White institutions
(PWI) versus historically Black colleges or universities (HBCU), that
needs to be further explored (Greer, 2007).
The goal of this paper was to describe how race and gender
can interact to influence the sexual risk behaviors of Black college
students with a specific interest on students attending HBCUs.
College students may not face some of the same inequalities as the
general population (e.g., lack of access to health care and education),
therefore, prevention interventions need to address the specific
challenges faced by this population. It must be noted that HIV
incidence in the United States is highest in the Southeastern region,
which is the same region of the United States which contains the
highest concentration of HBCUs. College students often have sexual
partners who are not college students; therefore, it is imperative that
risk be conceptualized from a comprehensive perspective.
The nature of college campuses dictate that college students
will be exposed to an abundance of sexual risk knowledge, but as
demonstrated in numerous studies, knowledge alone is not enough
to promote healthy behaviors. Despite the increased levels of self-
report risky sexual behaviors, college students in general and Black
college students inaccurately do not perceive themselves to be at
risk (Braithwaite, Stephens, Sumpter-Gaddist, Murdaugh, Taylor,
& Braithwaite, 1998; Payne, 2006). It is important to examine the
reasons why Black college students still participate in risky behaviors
despite their knowledge of the HIV/AIDS epidemic within the
Black community. Some studies indicate that these personal fables
of the consequences of sexually risky behaviors may be culturally
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influenced. In order for prevention researchers and practitioners to
be proactive and prevent Black college students from being the next
leading group in the HIV/AIDS epidemic, more research and effective
interventions are critical. Lastly, it is not enough for researchers to
take conceptual models developed on White college student samples
and simply generalize them to Black college students. Instead,
the nuances of this group should be understood from a culturally
congruent perspective.
Future Directions
A large multi-site epidemiological study should be conducted
on college campuses with adequate samples of Black students. There
is an increased need for more accurate estimations of the STI/
HIV incidence and prevalence rates of Black on college campuses.
Second, in order to test some of the questions raised in this paper
(i.e., protective/risk factors of HBCUs), the environments of Black
students attending HBCUs and those attending PWIs should be
examined and compared. Lastly, those individuals who are practicing
healthy behaviors and in turn lowering their sexual risk, should
be examined in depth. Correlates of protective behaviors can be
identified and implemented into effective interventions.
Younge, ET AL. 53
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Recommended Citation
African American College Students' Attitudes_resized
HIV-AIDS Perceptions, Attitudes & Behaviors Among HBCU Students_resized
Intersection Between Race, Gender, & Sexual Risk_resized
Promoting HIV Vaccine Research in African American Communities_resized