Urban African-American and Hispanic adolescents and young adults: who do they talk to about AIDS and condoms? What are they learning?

Abstract

This paper reports on the first qualitative part of a study designed to investigate factors related to the use of condoms among African-American and Hispanic adolescents and young adults in Detroit. This paper describes who young, urban, African-American and Hispanic persons talk to about AIDS and condoms and what they are learning. The paper provides data on attitudes and beliefs about AIDS and condoms that are needed for further research and for prevention programs.

PIP: A summary of qualitative results from a convenience sample of 30 Hispanic and 34 African American males and females 15-21 years in 1989 in Detroit (low socioeconomic status) and an open ended set of questions about acquired immunodeficiency syndrome (AIDS) and condom use are provided. The results are not generalizable to all urban minority youth or African American and Hispanic youth, or comparable to nonminority peers. The literature was lacking in ethnic differences in condom beliefs, the identification of barriers to AIDS risk reduction (knowledge of AIDS transmission, assessment of vulnerability, and positive and negative attitudes to condoms), and who adolescents talk to about AIDS. The objective was to fill in the gaps for the purpose of developing intervention programs specific to this population. The instrument questioned 1) knowledge of AIDS and condoms, 2) who youth talk to about AIDS and condoms and what is said, 2) sexual experience, 4) condom use, and 5) drug use. Content was analyzed and reliability was assessed satisfactorily with Cohen's kappa (p.05). Special selection and training procedures were used to solicit truthfulness, i.e., interviewers were matched by gender and ethnicity and trained to deal with silence, confidentiality and anonymity issues, and minimize stress. The results showed that most talked with someone about AIDS (68% black and 87% Hispanic). Both talked most often with friends or siblings followed by parents and then teachers and counselors. Hispanics talked more to teachers than blacks and African Americans talked more to friends. Misleading messages were given to African American on not to worry about AIDS (9%) and choosing safe sex partners (35%). Over 50% were given facts about AIDS vs. Hispanics who were given worry messages. 19% of Hispanics were told to protect themselves with safe sex partners; no one was told not to worry. Most knew the traditional modes of transmission, but few knew about placental transmission (0%-23%), and women (41%-47%) knew of blood transfusion transmission in contrast to men (12%-13%). Approximately 50% of African American and Hispanic men thought it was possible to AIDS, and 71% of African American Women but only 27% of Hispanic women thought it was possible. Most thought sexual contact made them vulnerable or avoidance behavior protected them. Positive beliefs about condom protection from AIDS were generally agreed upon, but variation existed in negative beliefs, and may voiced concerns about condom breakage, discomfort, and reduction in sexual pleasure. Education needs to address these concerns and, for Hispanic women, reproductive biology and health needs promotion and guidance in performance of AIDS reduction actions. The quality of these information channels needs improvement.