Black teenage women who frequently participate in religious or spiritual activities are more likely than those who do not to engage in behaviors and hold attitudes that lower their risk of acquiring HIV and other sexually transmitted diseases (STDs).1 In a survey of Southern women in an STD prevention trial, young women who indicated a high degree of religiosity had significantly elevated odds of reporting that they felt able to communicate with partners and refuse unsafe sexual encounters, as well as increased odds of having positive attitudes toward condom use. These findings, as the researchers remark, may have implications for the design of faith-based initiatives to prevent STDs among young people.
The survey was conducted between December 1996 and April 1999 among women attending adolescent medicine clinics, health department clinics and school health classes in neighborhoods with high STD rates. To participate, women had to be 14-18 years old and had to have had voluntary vaginal intercourse with a man in the previous six months. The sample consisted of 522 teenagers, who completed self-administered questionnaires exploring their religious involvement and structured interviews focusing on their sexual behavior.
Most participants were older than 15 (65%), were in school (91%) and lived with a single parent (58% with their mother and 2% with their father). Seventy-two percent identified themselves as Baptists, 16% as Protestants and 2% as adherents of other religions; 10% reported no religious affiliation. Overall, the women in the sample reported a high degree of religiosity: Sixty-four percent of respondents scored above the median on a scale reflecting how often women attend religious services, pray or meditate, talk to others about religious or spiritual concerns, and speak with a religious or spiritual leader.
Between 57% and 68% of participants who scored high on the religiosity scale also scored above the median on scales measuring women's confidence in their ability to talk with partners about sex, confidence in their ability to refuse to engage in risky behavior and attitudes toward condoms. By contrast, 38-48% of women reporting low levels of religiosity scored high on the self-efficacy and condom scales, and the differences were statistically significant at the univariate level. Likewise, women with high levels of religious involvement were more likely than those with low religiosity to have begun having sex after age 14 (54% vs. 42%) and to have used condoms in the previous six months (88% vs. 12%).
Results of multivariate regression analysis confirmed most of the associations found at the univariate level. A high degree of religious involvement was associated with significantly elevated odds that women scored high on scales measuring their self-efficacy with regard to talking with a new or steady partner about sex, talking about STD and pregnancy prevention with a partner, and refusing to participate in unsafe sexual activity (odds ratios, 1.9-2.5); it was also associated with positive attitudes toward condom use (1.5). Women scoring high on the religiosity scale were more likely than those scoring below the median to have first had sex after age 14 (1.5); their odds of having used condoms at some time in the last six months appeared to be higher than those of less-religious women, but the difference was only marginally significant.
The researchers acknowledge that the study has a number of limitations; notably, because the sample comprised only black teenage women living in "high-risk social environments" in the South, the great majority of whom were Baptist, the findings may not be generalizable to males or to teenagers of other backgrounds. Nevertheless, the investigators conclude that faith-based programs may have a role to play in preventing HIV and other STDs among some teenagers. They note that their findings are consistent with the literature suggesting that such initiatives may be "acceptable, credible, and...effective ways to reach and educate African-Americans regarding HIV prevention."
1. McCree DH et al., Religiosity and risky sexual behavior in African-American adolescent females, Journal of Adolescent Health, 2003, 33(1):2-8.