Black females in the United States disproportionately suffer from STDs, including HIV. Understanding the sociocultural conditions that affect their risk is essential to developing effective and culturally relevant prevention programs.
In 2016–2017 in Madison, Wisconsin, 20 black females aged 19–62 completed interviews that explored the sociocultural conditions associated with sexual development and STD/HIV risk. Interviews were guided by grounded theory; open, axial and selective coding and constant comparative analysis were used to identify developmental phases and relevant sociocultural conditions.
Three phases of becoming a sexual black woman were identified: Girl, when participants reported beginning to understand their sexuality; Grown, marking a transition to adulthood, when participants began to feel more self‐sufficient yet still grappled with their emerging sexuality; and Woman, when participants developed a strong sense of self and took ownership of their bodies. Two sociocultural conditions affected progression through these phases: stereotype messaging and protection (both self‐protection and protecting others). Negative life events (e.g., sexual trauma) and early sexualization reportedly affected sexual development, and STD experience influenced self‐perceptions of sexuality and sexual behavior, often leading to self‐protective behaviors. Older participants reported strategies to protect young black females from negative sexual experiences.
Interventions at multiple levels of the social ecology throughout the life course may help reduce STD/HIV risk among black women in the United States. Future research should include examination of the experiences of black females younger than 18 and evaluation of the protective strategies employed by older black females.
Natasha Crooks is postdoctoral fellow, and Jessica McDermott Sales is associate professor, at the Rollins School of Public Health, Emory University, Atlanta. Barbara King and Audrey Tluczek are associate professors at the School of Nursing, University of Wisconsin–Madison.