The Process of Becoming a Sexual Black Woman: A Grounded Theory Study

Twenty million new sexually transmitted infections (STIs) occur annually in the United States costing approximately $16 billion. Each year 1 in 4 women contracts an STI, which can be detrimental to women, placing them at risk for other STIs (e.g. HIV) and more serious health consequences. Black females aged 15-24 have disproportionately higher STI infection rates, than other racial/ethnic groups. Despite efforts to make the information about transmission and prevention available to Black females, STIs rates including repeat infection in Black females remain the highest of all racial/ethnic groups. Researchers have identified threats to the sexual health of Black females including adverse sociocultural conditions, (e.g., poverty, poor access to care, relational power differentials and cultural norms). Although previous researchers acknowledge that young Black females face unique sociocultural conditions that increase risk for STIs/HIV, research to date has not explained the mechanisms by which such sociocultural conditions contribute to increasing STI risk. Gaining an understanding of the sociocultural conditions that influence the process of becoming a sexual Black woman and the impact of STIs is essential to inform interventions to reduce STI risk. Therefore the purpose of the current study was to explore how sociocultural conditions influence the process of becoming a sexual Black woman and STI risk. Study findings led to a conceptual model that explains this process. The model shows three distinct phases in sexual development, i.e., Girl, Grown, and Woman. Additionally, this model describes two sexual pathways that Black females could take (i.e., Fast or Cautious). Previous STIs influenced how Black women viewed their sexuality and their sexual behavior, often leading to self-protective behavior. Becoming a sexual Black woman was also influenced by Protection (of self-and/or from others) and Stereotype Messaging. Negative life events, such as sexual trauma and early sexualization, activated protection and risk behaviors. Findings from this study can inform future evidence-based interventions to promote the sexual health of Black women.