“We Feel Like Everybody&apos;s Going to Judge us”: Black Adolescent Girls’ and Young Women&apos;s Perspectives on Barriers to and Opportunities for Improving Sexual Health Care, Including PrEP, in the Southern U.S

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Abstract

Black adolescent girls and young women (AGYW) are disproportionately affected by HIV in the southern U.S.; however, PrEP prescriptions to Black AGYW remain scarce. We conducted in-depth interviews (IDIs) with Black AGYW ages 14-24 in Alabama to explore opportunities for and barriers to sexual health care including PrEP prescription. Twelve AGYW participated in IDIs with median age 20 (range 19-24). All reported condomless sex, 1-3 sexual partners in the past 3 months, and 6 reported prior STI. Themes included: 1) Stigma related to sex contributes to inadequate discussions with educators, healthcare providers, and parents about sexual health; 2) Intersecting stigmas around race and gender impact Black women's care-seeking behavior; 3) Many AGYW are aware of PrEP but don't perceive it as an option for them. Multifaceted interventions utilizing the perspectives, voices, and experiences of Black cisgender AGYW are needed to curb the HIV epidemic in Alabama and the U.S. South.

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Three approaches to qualitative content analysis.

Hsiu-Fang Hsieh, Sarah Shannon (2016)

Content analysis is a widely used qualitative research technique. Rather than being a single method, current applications of content analysis show three distinct approaches: conventional, directed, or summative. All three approaches are used to interpret meaning from the content of text data and, hence, adhere to the naturalistic paradigm. The major differences among the approaches are coding schemes, origins of codes, and threats to trustworthiness. In conventional content analysis, coding categories are derived directly from the text data. With a directed approach, analysis starts with a theory or relevant research findings as guidance for initial codes. A summative content analysis involves counting and comparisons, usually of keywords or content, followed by the interpretation of the underlying context. The authors delineate analytic procedures specific to each approach and techniques addressing trustworthiness with hypothetical examples drawn from the area of end-of-life care.

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The qualitative content analysis process.

Satu Elo, Helvi Kyngäs (2008)

This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.

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Is Open Access

Re-revisiting Andersen’s Behavioral Model of Health Services Use: a systematic review of studies from 1998–2011

Birgit Babitsch, Daniela Gohl, Thomas von Lengerke (2012)

Objective: This systematic review aims to assess the use and implementation of the Behavioral Model of Health Services Use developed by Ronald M. Andersen in recent studies explicity using this model. Methods: A systematic search was conducted using PubMed in April 2011. The search strategy aimed to identify all articles in which the Andersen model had been applied and which had been published between 1998 and March 2011 in English or German. The search yielded a total of 328 articles. Two researchers independently reviewed the retrieved articles for possible inclusion using a three-step selection process (1. title/author, 2. abstract, 3. full text) with pre-defined inclusion and exclusion criteria for each step. 16 studies met all of the inclusion criteria and were used for analysis. A data extraction form was developed to collect information from articles on 17 categories including author, title, population description, aim of the study, methodological approach, use of the Andersen model, applied model version, and main results. The data collected were collated into six main categories and are presented accordingly. Results: Andersen’s Behavioral Model (BM) has been used extensively in studies investigating the use of health services. The studies identified for this review showed that the model has been used in several areas of the health care system and in relation to very different diseases. The 1995 version of the BM was the version most frequently applied in the studies. However, the studies showed substantial differences in the variables used. The majority of the reviewed studies included age (N=15), marital status (N=13), gender/sex (N=12), education (N=11), and ethnicity (N=10) as predisposing factors and income/financial situation (N=10), health insurance (N=9), and having a usual source of care/family doctor (N=9) as enabling factors. As need factors, most of the studies included evaluated health status (N=13) and self-reported/perceived health (N=9) as well as a very wide variety of diseases. Although associations were found between the main factors examined in the studies and the utilization of health care, there was a lack of consistency in these findings. The context of the studies reviewed and the characteristics of the study populations seemed to have a strong impact on the existence, strength and direction of these associations. Conclusions: Although the frequently used BM was explicitly employed as the theoretical background for the reviewed studies, their operationalizations of the model revealed that only a small common set of variables was used and that there were huge variations in the way these variables were categorized, especially as it concerns predisposing and enabling factors. This may stem from the secondary data sets used in the majority of the studies, which limited the variables available for study. Primary studies are urgently needed to enrich our understanding of health care utilization and the complexity of the processes shown in the BM.

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Author and article information

Journal

Journal ID (nlm-ta): J Int Assoc Provid AIDS Care

Journal ID (iso-abbrev): J Int Assoc Provid AIDS Care

Journal ID (publisher-id): JIA

Journal ID (hwp): spjia

Title: Journal of the International Association of Providers of AIDS Care

Publisher: SAGE Publications (Sage CA: Los Angeles, CA )

ISSN (Print): 2325-9574

ISSN (Electronic): 2325-9582

Publication date (Electronic): 14 June 2022

Publication date Collection: Jan-Dec 2022

Volume: 21

Electronic Location Identifier: 23259582221107327

Affiliations

[1 ]Division of Infectious Diseases, Department of Medicine, School of Medicine, Ringgold 9968, universityUniversity of Alabama at Birmingham (UAB); , Birmingham, AL, USA

[2 ]Ringgold 3776, universityHaverford College; , Haverford, PA, USA

[3 ]Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, Ringgold 9968, universityUniversity of Alabama at Birmingham; , Birmingham, AL, USA

[4 ]School of Medicine, Ringgold 9968, universityUniversity of Alabama at Birmingham; , Birmingham, AL, USA

[5 ]Department of Health Behavior, School of Public Health, Ringgold 9968, universityUniversity of Alabama at Birmingham; , Birmingham, AL, USA

Author notes

[*]Madeline C. Pratt, Department of Medicine, Division of Infectious Diseases, The University of Alabama at Birmingham, Ziegler Research Building 210, 1720 2nd Ave S, Birmingham, AL 35294, USA. Email: mcpratt@ 123456uabmc.edu

Author information

Madeline C. Pratt https://orcid.org/0000-0003-2255-0401

Article

Publisher ID: 10.1177_23259582221107327

DOI: 10.1177/23259582221107327

PMC ID: 9201301

PubMed ID: 35699978

SO-VID: c2c1d757-9fed-4cb5-ac41-893b90e5f5a9

License:

This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

History

Date received : 9 March 2022

Date revision received : 17 May 2022

Date accepted : 29 May 2022

Funding

Funded by: National Institute of Allergy and Infectious Diseases, FundRef https://doi.org/10.13039/100000060;

Award ID: P30 AI027767

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typesetter ts19

cover-date January-December 2022

Keywords: adolescents,hiv pre-exposure prophylaxis,sexual health,women and girls,u.s. south

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Keywords: adolescents, hiv pre-exposure prophylaxis, sexual health, women and girls, u.s. south

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“We Feel Like Everybody's Going to Judge us”: Black Adolescent Girls’ and Young Women's Perspectives on Barriers to and Opportunities for Improving Sexual Health Care, Including PrEP, in the Southern U.S

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HTI Journal of African and African Diasporic Studies/ La revue des études sur l'Afrique et la diaspora africaine

Most cited references 38

Three approaches to qualitative content analysis.

The qualitative content analysis process.

Re-revisiting Andersen’s Behavioral Model of Health Services Use: a systematic review of studies from 1998–2011

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Cited by 7

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