Safer sex strategies and the role of gender among African American youth transitioning from foster care

Estimates indicate that each year nearly half of all the reported new cases of sexually transmitted infections (STIs) in the United States are acquired by youth 15-24 years old with young women of color disproportionately bearing the burden of infections. The sexual health risks of STIs and their associated racial and gender disparities also exist among young people in foster care, yet questions remain about their use of primary and secondary prevention methods that limit their exposure to infections. Using a sequential, mixed methods approach, data from 115 sexually active African American youth (17-20 years old) were analyzed to determine their level of protection and whether gender was a factor in their prevention efforts. Qualitative interviews were then conducted with 18 of the youth who reported high levels of protection against STIs/HIV to explore gender differences in perceptions of prevention strategies. The study's quantitative results suggest that condom use among African American youth in foster care is at least as high if not higher than their peers in the general population while STI/HIV testing is used at a much higher rate. Qualitative results point to gender differences in perceptions of condom use and STI/HIV testing, with some young women reporting difficulties with obtaining and negotiating the use of condoms. In contrast, young women considered testing a psychologically safe, tangible and protective alternative in caring for their sexual health. Implications and recommendations for child welfare and health professionals and direction for future research are discussed.