Sarah J. Reed

Identity and Agency: The Meaning and Value of Pregnancy for Young Black Lesbians

Young sexual minority women disproportionately experience pregnancy, repeat pregnancy, and become parents, when compared with their heterosexual peers. Black sexual minority women who are socioeconomically disadvantaged are a part of three demographic groups likely to experience adolescent pregnancy. A paucity of research has examined why these young women become pregnant. The authors begin to address this gap by examining the meaning of pregnancy from young women’s perspective. Modified grounded theory was used to analyze data from interviews with 14 young Black sexual minority women, aged 16–24. Pregnancies, intentional and unintentional, were common among the participants and within their sexual minority community. Pregnancy affirmed sexual identity and same-sex relationships as well as garnered sexual and reproductive agency. Participants’ pregnancy experiences contradicted the belief that young women sought or valued pregnancy because it provided access to heterosexual privilege. Although the main functions of intentional pregnancies did not differ drastically from those of young heterosexual women, we argue that these young women’s pregnancy and parenting desires may be magnified because of the particular realities they face as sexual minority women. Further, we situate our analysis within the context of a Black cultural environment and argue that pregnancy and motherhood may be adaptive subsistence strategies for women who are largely socially devalued.

Conflict Transformation, Stigma, and HIV-Preventive Structural Change

Over the prior decade, structural change efforts have become an important component of community-based HIV prevention initiatives. However, these efforts may not succeed when structural change initiatives encounter political resistance or invoke conflicting values, which may be likely when changes are intended to benefit a stigmatized population. The current study sought to examine the impact of target population stigma on the ability of 13 community coalitions to achieve structural change objectives. Results indicated that coalitions working on behalf of highly stigmatized populations had to abandon objectives more often than did coalitions working for less stigmatized populations because of external opposition to coalition objectives and resultant internal conflict over goals. Those coalitions that were most successful in meeting external challenges used opposition and conflict as transformative occasions by targeting conflicts directly and attempting to neutralize oppositional groups or turn them into strategic allies; less successful coalitions working on behalf of stigmatized groups struggled to determine an appropriate response to opposition. The role of conflict transformation as a success strategy for working on behalf of stigmatized groups is discussed.

Sexual Debut of Young Black Women Who Have Sex With Women Implications for STI/HIV Risk

Young Black women continue to be at high risk for HIV and sexually transmitted infections (STIs). However, little is known about the risks specifically to young Black women who primarily have sex with women (YWSW). As part of a larger sexual health project, in-depth qualitative interviews were completed with 14 Black women ages 16-24, who identified as lesbian. Using within and cross-case analysis, this article explores their consensual sexual debut experiences with both males and females. The most obvious indicator of risk was the almost universal lack of safer sex practices. Other risks include the context of the debuts including young ages of debut, lack of adult supervision, use of alcohol, and lack of agency in female debuts. The two motivations for debuting with males that may put young women at increased risk are intent to get pregnant and the need to “cover up” or “test” sexual attraction.

Accomplishing Structural Change: Identifying Intermediate Indicators of Success

Coalitions are routinely employed across the United States as a method of mobilizing communities to improve local conditions that impact on citizens’ well-being. Success in achieving specific objectives for environmental or structural community change may not quickly translate into improved population outcomes in the community, posing a dilemma for coalitions that pursue changes that focus on altering community conditions. Considerable effort by communities to plan for and pursue structural change objectives, without evidence of logical and appropriate intermediate markers of success could lead to wasted effort. Yet, the current literature provides little guidance on how coalitions might select intermediate indicators of achievement to judge their progress and the utility of their effort. The current paper explores the strengths and weaknesses of various indicators of intermediate success in creating structural changes among a sample of 13 coalitions organized to prevent exposure to HIV among high-risk adolescents in their local communities.

The Benefits of Youth Engagement in HIV-Preventive Structural Change Interventions

Youth are infrequently included in planning the health promotion projects designed to benefit them as many of the factors infringing upon youth’s health and well-being also limit their engagement in community-based public health promotion projects. This article explores youth engagement in 13 coalitions implementing structural changes meant to reduce HIV transmission among adolescents. There was wide variation of youth membership and involvement across coalitions. Using analytic induction, the authors show that youth engagement was associated with the successful completion of structural change efforts. The authors also describe how youth engagement indirectly facilitated coalitions’ success. The authors suggest that youth engagement in planning and conducting structural interventions is itself a valuable structural change.

The Influence of Community Context on How Coalitions Achieve HIV-Preventive Structural Change

Community coalition action theory (CCAT) depicts the processes and factors that affect coalition formation, maintenance, institutionalization, actions, and outcomes. CCAT proposes that community context affects coalitions at every phase of development and operation. We analyzed data from 12 Connect to Protect coalitions using inductive content analysis to examine how contextual factors (e.g., economics, collaboration, history, norms, and politics) enhance or impede coalitions’ success in achieving outcomes. Consistent with CCAT, context affected the objectives that coalitions developed and those they completed. Results suggest that local prevention history and political support have particular impact on coalitions’ success in creating structural changes. These data underscore the heuristic value of CCAT, yet also imply that the contextual constructs that affect outcomes are issue specific.

Influences on Sexual Partnering Among African American Adolescents With Concurrent Sexual Relationships

Adolescents often engage in concurrent sexual partnerships as part of a developmental process of gaining experience with sexuality. The authors qualitatively examined patterns of concurrency and variation in normative and motivational influences on this pattern of sexual partnering among African American adolescents (31 males; 20 females), ages 15 to 17 years. Using content analysis, gender and contextual differences in social norms and motivations for concurrency were explored. Findings describe the normative influences on adolescent males and females with regard to sexual concurrency and the transfer of these norms from one generation to the next.

“It Ain't All as Bad as it May Seem”: Young Black Lesbians' Responses to Sexual Prejudice

This article explores the ways in which young, Black lesbians manage their sexual minority identity when experiencing sexual prejudice. Fourteen Black lesbians between the ages of 16 and 24 participated in semistructured interviews. Instances of sexual prejudice and the young womens responses were thematically analyzed using open and axial qualitative coding techniques. Results indicated that participants experienced sexual prejudice frequently and even within the lesbian community. Responses to sexual prejudice included: cognitive reframing of heterosexist messages, passing, gaining support from self-created gay families, and fighting back (physically and verbally) in the event of isolated instances of sexual prejudice. Analysis focuses on how gender identity relates to experiences of sexual prejudice and identity management strategies. Findings suggest that there are parallels between the management strategies of these women and young, Black gay and bisexual males and between these women and Black women who are coping with sexism and racism.

The Effect of Trauma on Recent Inconsistent Condom Use Among Young Black Gay and Bisexual Men

The authors examined lifetime prevalence of sexual assault, emotional abuse, and physical violence, in a statewide sample of 180 Black gay and bisexual males ages 14 to 24. Rates of exposure to each form of abuse was high; 33% reported sexual assault, 74% reported at least one type of physical violence, and 91% reported at least one type of emotional abuse. Co-occurring trauma was the dominant pattern. Sexual assault and number of types of trauma experienced were associated with inconsistent condom use. Physical violence and number of types of trauma experienced were associated with depression and substance abuse. Implications for intervention are discussed.

“If It Weren’t for Them, I’d Probably Be Lost”: The Diversity and Function of Natural Mentors Among Young Black Men Who Have Sex With Men

The purpose of this study was to examine one interpersonal relationship—natural mentoring relationships—that may promote healthy development among young Black men who have sex with men (YBMSM), a population at disproportionate risk of multiple psychosocial health issues. We analyzed data from interviews with 168 YBMSM. We used content analysis to identify who participants cited as mentors, their personal characteristics, and the functions they played in youths’ lives. Participants frequently cited women and family members as mentors. Participants preferred as mentors people with whom they shared key attributes and who they considered successful and resilient. Mentors played roles in participant’s identity construction, cognitive development, and emotional development. Findings suggest that mentors have significant influence in the development of YBMSM. Incorporating natural mentors into health promotion interventions may be one means of enhancing the cultural relevance of interventions for this population.