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HIV prevention interventions to reduce sexual risk for African Americans: The influence of community-level stigma and psychological processes

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  • Reid, Allecia E.
  • Dovidio, John F.
  • Ballester, Estrellita
  • Johnson, Blair T.

Abstract

Interventions to improve public health may benefit from consideration of how environmental contexts can facilitate or hinder their success. We examined the extent to which efficacy of interventions to improve African Americans' condom use practices was moderated by two indicators of structural stigma—Whites' attitudes toward African Americans and residential segregation in the communities where interventions occurred. A previously published meta-analytic database was re-analyzed to examine the interplay of community-level stigma with the psychological processes implied by intervention content in influencing intervention efficacy. All studies were conducted in the United States and included samples that were at least 50% African American. Whites' attitudes were drawn from the American National Election Studies, which collects data from nationally representative samples. Residential segregation was drawn from published reports. Results showed independent effects of Whites' attitudes and residential segregation on condom use effect sizes. Interventions were most successful when Whites' attitudes were more positive or when residential segregation was low. These two structural factors interacted: Interventions improved condom use only when communities had both relatively positive attitudes toward African Americans and lower levels of segregation. The effect of Whites' attitudes was more pronounced at longer follow-up intervals and for younger samples and those samples with more African Americans. Tailoring content to participants' values and needs, which may reduce African Americans' mistrust of intervention providers, buffered against the negative influence of Whites' attitudes on condom use. The structural factors uniquely accounted for variance in condom use effect sizes over and above intervention-level features and community-level education and poverty. Results highlight the interplay of social identity and environment in perpetuating intergroup disparities. Potential mechanisms for these effects are discussed along with public health implications.

Suggested Citation

  • Reid, Allecia E. & Dovidio, John F. & Ballester, Estrellita & Johnson, Blair T., 2014. "HIV prevention interventions to reduce sexual risk for African Americans: The influence of community-level stigma and psychological processes," Social Science & Medicine, Elsevier, vol. 103(C), pages 118-125.
    • Handle: RePEc:eee:socmed:v:103:y:2014:i:c:p:118-125
    DOI: 10.1016/j.socscimed.2013.06.028
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    References listed on IDEAS

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    Cited by:

    1. Burke, Sara E. & Calabrese, Sarah K. & Dovidio, John F. & Levina, Olga S. & Uusküla, Anneli & Niccolai, Linda M. & Abel-Ollo, Katri & Heimer, Robert, 2015. "A tale of two cities: Stigma and health outcomes among people with HIV who inject drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia," Social Science & Medicine, Elsevier, vol. 130(C), pages 154-161.
    2. Reid, Allecia E. & Rosenthal, Lisa & Earnshaw, Valerie A. & Lewis, Tené T. & Lewis, Jessica B. & Stasko, Emily C. & Tobin, Jonathan N. & Ickovics, Jeannette R., 2016. "Discrimination and excessive weight gain during pregnancy among Black and Latina young women," Social Science & Medicine, Elsevier, vol. 156(C), pages 134-141.
    3. Kellogg, Alexander J. & Hancock, David W. & Cho, Grace Y. & Reid, Allecia E., 2023. "Community-level age bias and older adult mortality," Social Science & Medicine, Elsevier, vol. 317(C).
    4. Kellogg, Alexander J. & Hancock, David W. & Cho, Grace Y. & Reid, Allecia E., 2023. "Reprint of: Community-level age bias and older adult mortality," Social Science & Medicine, Elsevier, vol. 320(C).
    5. Johnson, Blair T. & Acabchuk, Rebecca L., 2018. "What are the keys to a longer, happier life? Answers from five decades of health psychology research," Social Science & Medicine, Elsevier, vol. 196(C), pages 218-226.
    6. Alexandra Morales & José P Espada & Mireia Orgilés & Silvia Escribano & Blair T Johnson & Marguerita Lightfoot, 2018. "Interventions to reduce risk for sexually transmitted infections in adolescents: A meta-analysis of trials, 2008-2016," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-26, June.
    7. Trani, Jean-Francois & Ballard, Ellis & Peña, Juan B., 2016. "Stigma of persons with disabilities in Afghanistan: Examining the pathways from stereotyping to mental distress," Social Science & Medicine, Elsevier, vol. 153(C), pages 258-265.
    8. Reid, Allecia E. & Earnshaw, Valerie A., 2023. "Embracing heterogeneity: Implications for research on stigma, discrimination, and African Americans’ health," Social Science & Medicine, Elsevier, vol. 316(C).

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