Logie Carmen H, Okumu Moses, Ryan Shannon, Yehdego Mary
Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada.
Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Canada.
Int J Behav Med. 2018 Aug;25(4):479-485. doi: 10.1007/s12529-018-9728-x.
African, Caribbean, and Black (ACB) women in Canada are disproportionately impacted by HIV and other sexually transmitted infections. Although there is reported suboptimal consistent condom use with ACB women, limited research has explored safer sex communication among this population. Coping frameworks highlight the role that resilient coping and condom use self-efficacy may play in facilitating safer sex communication. Structural perspectives stress the need to explore associations between HIV vulnerabilities and food insecurity. We examined pathways from resilient coping to safer sex communication through the mediator of condom use self-efficacy among ACB women in Toronto.
We conducted a cross-sectional survey with a purposive sample of ACB women aged 16 and older across Toronto, Canada. We conducted path analysis to test the direct effects of resilient coping on safer sex communication, and indirect pathways through the mediator (condom use self-efficacy) while controlling for food insecurity.
Participant (n = 80; mean age 27, SD 7.93) ethnicities included African (58.8%, n = 47), Caribbean (30%, n = 24), and others (11.3%, n = 9). Participants with food security reported significantly higher safer sex communication. We found no direct effect of resilient coping on safer sex communication. Findings support the hypothesized mediation process; resilient coping was associated with condom use self-efficacy, which in turn was associated with safer sex communication.
Findings that condom use self-efficacy mediated the association between resilient coping and safer sex communication align with theoretical assertions of the protective role of adaptive coping strategies. Findings can inform tailored HIV and STI preventive interventions with ACB women.
加拿大的非洲、加勒比和黑人（ACB）女性受艾滋病毒和其他性传播感染的影响尤为严重。尽管据报道ACB女性持续使用避孕套的情况不太理想，但针对这一人群中安全性行为沟通的研究却很有限。应对框架强调了弹性应对和避孕套使用自我效能感在促进安全性行为沟通中可能发挥的作用。结构视角强调有必要探索艾滋病毒易感性与粮食不安全之间的关联。我们研究了多伦多ACB女性中通过避孕套使用自我效能感这一中介因素，从弹性应对到安全性行为沟通的路径。
我们对加拿大多伦多16岁及以上的ACB女性进行了一项有目的抽样的横断面调查。我们进行了路径分析，以测试弹性应对对安全性行为沟通的直接影响，以及在控制粮食不安全的情况下通过中介因素（避孕套使用自我效能感）的间接路径。
参与者（n = 80；平均年龄27岁，标准差7.93）的种族包括非洲人（58.8%，n = 47）、加勒比人（30%，n = 24）和其他人（11.3%，n = 9）。粮食安全的参与者报告的安全性行为沟通显著更高。我们发现弹性应对对安全性行为沟通没有直接影响。研究结果支持了假设的中介过程；弹性应对与避孕套使用自我效能感相关，而避孕套使用自我效能感又与安全性行为沟通相关。
避孕套使用自我效能感介导了弹性应对与安全性行为沟通之间的关联，这一发现与适应性应对策略的保护作用的理论断言相一致。研究结果可为针对ACB女性的量身定制的艾滋病毒和性传播感染预防干预措施提供参考。
