All ETDs from UAB

Advisory Committee Chair

Linda Moneyham

Advisory Committee Members

Lucy Annang

Andres Azuero

Gwendolyn Childs

Pamela Payne-Foster

David Vance

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Introduction: HIV knowledge, high self-esteem, condom self-efficacy, positive attitudes toward condom use, and condom negotiation skills have been associated with decreased HIV risk behavior among women, but have not been examined within a framework of empowerment for sexual risk. Sexual pressure, inclusive of both coercive and noncoercive pressures to engage in unwanted or unprotected sex, has also not been studied in association with sexual empowerment as a framework or as a potential moderator between sexual empowerment and condom use among women of different racial groups. Study Purpose: 1) To explore the relationship between sexual empowerment and condom use; 2) to explore the moderating effect of sexual pressure on the relationship between sexual empowerment and condom use; and 3) to explore racial differences in sexual empowerment, sexual pressure, and condom use among young adult African American women (AAW) and Caucasian women (CW) ages 19-25. Methods: A convenience sample of AAW and CW ages 19-25 (N = 101- 50 AAW, 50 CW, 1 Biracial) was recruited from two local health department clinics located in a Southeastern metropolitan area. Statistical analyses included descriptive analyses, correlational analyses, logistic and linear regression, and t-tests. iv Major findings: Although positive attitudes toward condoms and condom negotiation skills were found to be associated with increased condom use, this relationship was negatively moderated in the context of sexual pressure. Also, women who were more likely to experience sexual pressure reported lower self-esteem and more negative attitudes toward condoms. AAW reported higher self-esteem, but lower condom negotiation skills than CW/Other. Although mean scores of sexual pressure did not differ between races, AAW scored significantly higher on the sexual coercion subscale. Condom use did not significantly differ between races. Conclusions: Identifying factors that empower women toward safer sexual practices is an important step in implementing effective HIV prevention interventions. In addition, empowerment interventions that target power imbalances and gender norms in sexual relationships will benefit from addressing ways in which to increase resistance to sexual pressure in both coercive and non-coercive situations. Lastly, researchers should tailor interventions based on the social context and ensure their relevance for various racial/ ethnic groups.

Included in

Nursing Commons



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