All ETDs from UAB

Advisory Committee Chair

Tamika L Smith

Advisory Committee Members

Jeffery T Walker

Susan L Davies

Gregory Pavela

Lonnie Hannon

Document Type

Dissertation

Date of Award

2023

Degree Name by School

Doctor of Philosophy (PhD) School of Public Health

Abstract

Introduction: HIV (Human Immunodeficiency Virus) is a sexually transmitted infection (STI) that is still a major health issue in the United States and the world. Emerging adults are more likely to engage in risky sexual behaviors such as multiple sexual partners and unprotected sex. HIV testing contributes to ending the HIV epidemic by identifying at-risk individuals and promoting early diagnosis.Methods: Secondary data analyses of the City Health II dataset were conducted to 1) identify the association between HIV testing and risky sexual behaviors among Black/African American emerging adults ages 18-25 years living in Birmingham metro area, 2) use social network theory to evaluate the relationship between ecological factors and HIV testing and safe sex practices among Black/African American emerging adults ages 18-25 years living in Birmingham metro area, and 3) use geospatial analysis to investigate the difference in the effects of ecological factors on HIV testing through proximity among Black/African American emerging adults ages 18-25 years. Results: The dataset had more females that males (53.4% vs. 46.6%), individuals who had never tested for HIV had an average age of 20 years. Among participants, 51.5% reported using condom, 73% didn’t use alcohol/substance before sex and 69% were in monogamous relationship. HIV testing was associated with age, and HIV knowledge. Physician recommendation showed significance in HIV testing. Those who reported having friends who tested for HIV were more likely to also test for HIV. Having friends that used a condom also increased the likelihood of participants’ condom use. The majority did not test at the nearest HIV testing site. Conclusion: Study findings highlights the need to understand ecological factors impacting HIV testing and safe sex practice. Sexual health education interventions can be tailored using the social ecological model giving a holistic approach to HIV prevention.

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