Minority Stress and Sexual Functioning Among African American Women With At-Risk Partners in South Los Angeles

Background: Preliminary evidence indicates that acute and chronic psychological stress affect sexual arousal and satisfaction. African American women, in particular, are vulnerable to the impacts of gender-and race-related stress, given their socially constructed identities as African Americans and as women. Aim: We examined associations between minority stress and sexual function using data from 248 African American women. Methods: Surveys were conducted with 248 African American women in South LA with male partners at risk for acquiring HIV. We analyzed self-reports on (i) stress indicators: chronic burden, perceived racism/sexism, and histories of trauma/sexual abuse; (ii) Female Sexual Function Index domains: desire, arousal, and satisfaction; and (iii) potential moderators: social support and spirituality. We used multiple regression, adjusting for potential confounding factors, to examine the relationships between stress indictors, potential moderators, and sexual function domains. Outcomes: The outcomes were the female sexual function index domains of desire, arousal, and satisfaction. Results: This largely low-income sample experienced significant chronic and acute stressors, was highly spiritual and reported strong social support. Moderate-high chronic burden and increasing sexism scores were independently associated with decreased arousal (B =-0.38, 95%CI =-0.75,-0.02) and satisfaction (B =-0.03, 95%CI =-0.06, 0.00) scores, respectively. Clinical Implications: Providers may want to explore chronic burden in patients who complain about low sexual arousal. Additionally, to develop effective HIV-and other STI-related interventions that impact behaviors that can confer sexual risk, prevention strategies are needed that either reduce contextual stressors or mitigate their impact. Strengths: Strengths of this research are that it focuses on sexual function among previously under-studied, low-income African American women and that it takes into account the unique set of stressors faced by these women. Limitations: A limitation is that the sample size may have been too small to capture the effects of potential moderators. Conclusions: Low-income African American women accumulate life stressors that may harm sexual function. Copyright (c) 2022, International Society of Sexual Medicine. Published by Elsevier Inc. All rights reserved.