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This study explored trajectories of perceived discrimination over a 17-year period from adolescence to adulthood and its association with sexual risk behavior, specifically, having multiple sex partners in adulthood in a sample of 343 African American and Puerto Rican women. Data were first collected on these women as students attending schools in the East Harlem area of New York City as part of the XXXXXXXXXX Study. The mean age of participants in the first wave was 14 years of age. To identify longitudinal trajectories of perceived discrimination, we utilized data from five assessments relating to mean ages: 19 years, 24 years, 29 years, 32 years, and 36 years. Perceived discrimination was measured using a three-item scale, experiences of discrimination, measured on a 4-point Likert scale that ranged from “not at all” (0) to “very much” (3). Items included questions about how much discrimination the respondent had experienced 1) at school, 2) by the police or security guards, and 3) if discrimination had ever affected their work or where they live. The Cronbach’s alphas for the items were 0.64, 0.74, 0.75, 0.77, and 0.77 at the five respective assessment timepoints. Bayesian Information Criteria (BIC) via growth mixture modeling was utilized to determine the number of trajectory groups (Muthén & Muthén, 2010; Nagin, 2005). Each participant was assigned to the trajectory group with the largest Bayesian posterior probability; trajectory group membership was then used to predict having multiple sex partners in adulthood. The measure of having multiple sex partners was assessed via a single item asking, “how many male sexual partners have you had in the past 6 months?” when the women were a mean age of 39 years.
Growth mixture modeling estimated three primary patterns of perceived discrimination from adolescence to the early 30’s of adulthood (Figure 1): low and decreasing (n=82, 26%), intermediate and persistent (n=174, 55%), and high and persistent (n=59, 19%). About 12% of women in the study had two or more sex partners in the past 6 months. Results (Table 1) indicated that, after adjusting for race/ethnicity, women who experience high and persistent levels of perceived discrimination from adolescence and throughout their life course, were more likely to have two or more male sex partners in adulthood as compared to those with membership in the low and decreasing perceived discrimination trajectory group (OR=3.34, p<0.05). Women with membership in the intermediate and persistent perceived trajectory group also experienced increased odds of having two or more male sex partners in their late 30’s as compared to those with membership in the low and decreasing perceived discrimination trajectory group even after controlling for race/ethnicity (OR=3.19, p<0.05). The results of this study support the hypothesis that perceived discrimination can impact future sexual risk behaviors among women. Further research is needed to identify pathways by which perceived discrimination can lead to sexual risk behaviors like having multiple sex partners, and to explore associations between perceived discrimination and other sexual risk behaviors such as sex with an untested partner.
Kerstin Pahl, New York University School of Medicine
Jung Yeon Lee, New York University School of Medicine
Sharifa Z Williams, Nathan S. Kline Institute for Psychiatric Research
Judith Brook, New York University School of Medicine