Mediating role of self-esteem: Black Caribbean and African American adolescents' initiation of sex.

To determine how self-esteem mediates the relationship between family support and initiation of sex for US-born Black Caribbean compared to African American adolescents. Secondary data analyses were performed on responses from 1170 adolescents from the National Survey of American Life-Adolescents supplement (2003-2004). Weighted descriptive statistics and logistic regression analyses were performed to examine whether initiation of sex on perceived family support is mediated by self-esteem. The study population consists of 360 Black Caribbean and 810 African American adolescents. Sexual initiation prevalence was higher for Black Caribbean adolescents (42.1%) than African American adolescents (36.75%). The adjusted odds ratio for Black Caribbean adolescents' initiation of sex was 0.85 (95% confidence interval [CI]: 0.16-4.51) compared to African American adolescents' 0.59 (95% CI: 0.35-1.00). Self-esteem represented a statistically significant mediation path and might be more important for African American adolescents' sexual health than the Black Caribbean. The unfounded mediating role of self-esteem between perceived family support and Black Caribbean adolescents' sexual initiation suggests possible influences of Black heterogeneity stemming from ethnic identity differences in sexual health decision-making.