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Sexual Partnerships, Risk Behaviors, and Condom Use Among Low-Income Heterosexual African Americans: A Qualitative Study

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Abstract

The purpose of the current investigation was to contextualize the sexual relationships and risk behaviors of heterosexually active African Americans. A total of 38 participants (20 females and 18 males) aged 18–44 years were recruited in a large city in the southeastern U.S. to participate in focus group discussions exploring sexual partnerships, general condom perceptions, and condom negotiation. Results indicated that participants distinguished among at least three partner types—one-night stand, “regular” casual partner, and main partner. Partner types were found to shape and influence types of sexual behaviors, perceptions of risk and condom use, and condom negotiation. Participants also shared general perceptions about condoms and elucidated situations in which intentions to use condoms were not realized. Gender differences emerged in many of these areas. Implications of these findings are discussed and directions for future research on sexual partnerships and risk behavior are offered.

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Acknowledgments

This project was funded by Grant # R34-MH077507 from the National Institute of Mental Health (Principal Investigator: Seth M. Noar). We would like to thank Dana Seay, Chandra Williams, and Deborah Washburn for their contributions to and support of this project.

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Authors and Affiliations

  1. School of Journalism and Mass Communication, University of North Carolina at Chapel Hill, 363 Carroll Hall, Chapel Hill, NC, 27599-3365, USA

    Seth M. Noar & Jessica Fitts Willoughby

  2. Department of Applied Health Science, The Kinsey Institute, Indiana University, Bloomington, IN, USA

    Elizabeth Webb

  3. Department of Communication, University of Kentucky, Lexington, KY, USA

    Stephanie Van Stee

  4. Department of Special Education and Rehabilitation, University of Kentucky, Lexington, KY, USA

    Sonja Feist-Price

  5. College of Public Health, University of Kentucky, Lexington, KY, USA

    Richard Crosby

  6. Louisville Metro Department of Health and Wellness, Louisville, KY, USA

    Adewale Troutman

Authors
  1. Seth M. Noar
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  2. Elizabeth Webb
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  3. Stephanie Van Stee
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  4. Sonja Feist-Price
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  5. Richard Crosby
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  6. Jessica Fitts Willoughby
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  7. Adewale Troutman
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Corresponding author

Correspondence to Seth M. Noar.

Appendix: Focus Group Discussion Questions

Appendix: Focus Group Discussion Questions

Relationships and Sexual Behavior

  • Do most people you know have a girlfriend or boyfriend? (i.e., primary partner).

    • Do some have additional casual partners too?

    • Do some only have casual partners? (no boyfriend/girlfriend)?

  • By what names do people refer to their boyfriend/girlfriend? To different kinds of casual sex partners? (e.g., friends with benefits).

  • Lets talk about sex now. When you hear the word ‘sex,’ what do you think of?

    • What is ‘sex?’ How do people define ‘sex?’ (probe: oral, vaginal, anal).

    • What words do people use to refer to oral sex? Vaginal sex? Anal sex?

  • Do people have different kinds of ‘sex’ with different kinds of partners? (e.g., steady versus casual).

  • How does one decide whether someone is ‘risky’ in terms of an STD or HIV?

    • Can you tell by looking?

    • How does one decide whether or not to use a condom?

  • Do people tend to use condoms with…

    • Their boyfriend/girlfriend?

    • With other kinds of sex partners?

    • Why or why not?

  • Do people tend to use condoms for certain types of sex but not others?

    • Oral sex?

    • Vaginal sex?

    • Anal sex?

    • Why or why not?

  • If you decide that you want to use a condom…

    • What do you say (or not say)? What do you do? Can you give me an example?

    • Does how you say it depend on the type of sex partner?

  • If you want to use condoms but your partner does not want to use them:

    • What do you say (or not say)? What do you do? Can you give me an example?

    • Does how you say it depend on the type of sex partner?

Condoms and Condom Use

  • What are some good things about using condoms? What are some bad things? What problems are there in using condoms? What makes it easier to use condoms? [Moderator: encourage respondents to give you examples of scenarios.]

  • What are reasons people you know don’t use condoms some of the time? [Moderator: you may need to probe—here are some examples: not for sale in town, sex isn’t the same with them, partner doesn’t want to use them]

    • Who makes this decision?

    • When is the decision made? (Moderator: for example—before date, during date, in the heat of the moment)

  • What are situations in which folks are most likely to use a condom?

    • What are situations in which you are least likely to use a condom? [Moderator: probe if necessary about: alcohol/drug use, when you’re really turned on, when you’re depressed, when risk of disease or pregnancy seems low]

  • Who influences you to use (or not use) condoms, and how much?

    • Sexual partner

    • Friends

    • Family

    • Others?

  • Sometimes, after couples have had sex for a while—and they know the female is on the pill—they stop using condoms. How do they make that decision? How do they decide that it’s now safe to stop using condoms?

Conclusion

  • Is there anything else you would like to add?

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Noar, S.M., Webb, E., Van Stee, S. et al. Sexual Partnerships, Risk Behaviors, and Condom Use Among Low-Income Heterosexual African Americans: A Qualitative Study. Arch Sex Behav 41, 959–970 (2012). https://doi.org/10.1007/s10508-011-9890-6

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