Theoretical Framework: The guiding framework for this study is Social Dominance Theory (SDT), a general theory of societal group-based inequality (Pratto, Sidanius, Stallworth & Malle, 1994). SDT was developed to understand how group-based power is structured and maintained within social and political hierarchies (Pratto, Sidanius & Levin, 2006). It attempts to synthesize psychological and sociological theories to explain group-based inequality and oppression based on age, gender and an arbitrary-set system (Pratto & Espinoza, 2001; Pratto, Sidanius & Levin, 2006; Rosenthal & Levy, 2010). SDT theorizes that in the age-system, adults have enormous power over children. In the gender system, which ascribes more power to men, “men have disproportionate social, political, and military power compared to women” (p. 273). It must also be noted that women tend to marry or have relationships with older men who wield much power over them. The same can be said of people who engage in homosexual relationships – age and male tendencies are usual characteristics common to the individual who wields more power in the relationship. SDT also highlights that in the arbitrary system, groups are constructed on “arbitrary” cultural bases. The main variable related to SDT is Social Dominance Orientation (SDO) (Pratto, Sidanius, Stallworth & Malle, 1994) which is being measured in this study in relation to its influence on sexual behavior.
SDT is structured around the four bases of gendered power (Pratto & Walker, 2001) - force; resource control (usually controlled by men); social obligations (which generally assure women’s subordination to men); and consensual ideologies (which dictate that men are in control). Therefore, a high social dominance orientation score indicates agreement with the ideology that men should be more socially dominant and have more power in gender-based relationships. These factors (force, resource control, social obligations, and consensual ideologies), can be helpful in explaining female vulnerability to STI infection.
Knowing that STI rates in the military far surpass those of the civilian population, and HIV data in the military reflect those of the general US population, and that more than 80% of HIV-infected women were infected through high risk heterosexual contact (CDC, 2013; Florida Department of Health Fact Sheet, 2013; KFF, 2014), it is logical to hypothesize that power imbalance in female Veterans’ heterosexual relationships may be contributing factors to high risk sex.
Specific Aims:
- Examine how female Veterans’ individual and demographic characteristics; cognitive and behavioral factors; socioeconomic factors; and, social dominance orientation are associated with each other.
- Explore the degree to which female Veterans’ individual and demographic characteristics; and, socioeconomic factors predict safer sex behaviors, STD knowledge and social dominance orientation.
Methods
Research Design: This proposed research utilizes a descriptive, correlational, cross-sectional, non-experimental design to describe high risk sexual behaviors and factors that predict high risk sex practices in female military Veterans.
Setting:The study occurs in the “real world” or in the “field” in the State of Florida, USA. Florida has one of the largest Veterans’ populations in the United States, many of whom are women. This population of Veteran women tends to be racially and ethnically diverse. Additionally, Florida is home to several VA hospitals. The majority of Veterans reside in the southern and central Veterans Integrated Service Networks (VISNs) of the United States. There are also several clinics and hospitals in all Florida counties, especially Miami-Dade, Broward and Palm Beach.
Population:The target population for this study is at least 116 female US military Veterans of any age, who are residents of the State of Florida. Participants may be men who identify as women, including Trans persons. Participants must be healthy enough to participate in study data collection protocols and be able to read, write and understand English. Potential participants will be excluded if they have any physical, cognitive or psychological impediments that prevent reliable and valid participation in the study protocol.
Sample Size:A priori power analysis utilizing G*Power was used to determine sample size based on an anticipated effect size of .30 or higher to achieve statistically significant differences at the significance level (alpha) of .05 and a minimum power of .80.
Data Collection:The Florida International University (FIU) IRB has approved the study and data are being collected electronically or on paper, based on participant’s choice, from the community. Additional approval from the VA IRB is pending. All necessary measures have been implemented to safeguard privacy, confidentiality and anonymity. Qualtrics is the electronic data platform and The PI worked with Qualtrics (electronic data platform) engineers to design tools so that privacy, confidentiality and anonymity are assured.
Women who decide not to participate are thanked and no further contact is made. Those who meet criteria and wish to participate are escorted to a private area where they are given the study questionnaires for completion. The PI intervenes only if the participant has a question or needs clarification. Completed surveys are coded for anonymity, and placed in a sealed envelope by the participant. Before sealing the envelope, participants are asked if they have any further questions. If not, the envelope is collected and the participant is given a gift card in the amount of $10.00 for having participated. Those who desire to complete the surveys electronically, a web link to the surveys is sent to their email. The irretrievable, random generated code is then noted by the participant and sent to the PI, indicating survey completion so that the gift certificate can be sent to the participant. The code is deleted, if missed. The VA does not allow gifts to study participants. They waived the informed consent for an Information Letter instead because no patient data is being collected.
Instruments and Psychometrics:
- PI Developed Screening Form
- PI Developed Demographic Questionnaire
- The Safer Sex Behavior Questionnaire ([SSBQ], DiIorio, Parsons, Lehr, Adame & Carlone,1992);Cronbach’s Alpha of .52 to .85; stability females (r = .63 to .82); males (r = .35 to .84); validity: -.34 and .39 for males; -.21 and .27 for females
- Social Dominance Orientation Scale ([SDO] Pratto, Sidanius, Stallworth & Malle, 1994); internal reliability: .83, ranging from .31 to .63; stability: .81 to .72
- STD Knowledge Questionnaire (Jaworski & Carey, 2007); The STD-KQ - internal consistency (Alpha = .86) and test–retest reliability (r = .88) over a brief period
- The Abuse Assessment Tool – Short Form (McWhinney-Dehaney, 2006); The AATNP Short Form had a Cronbach’s alpha of .93.Item-to-total statistics ranged from .56 to .76; Alpha-if-item deleted was .93 or less.
Major Concepts:Demographics (age, SES, education, race, length of residence in the USA, nationality, HIV status, culture, religious engagement); safer sex practices; SDO; STD knowledge; and abuse in relationships.
Data Analysis:Data are currently being collected with almost half of the participant quota met. The latest version of SPSS will be used for descriptive and multivariate statistical analyses. The criterion level for significance will be .05. Specific statistical analyses will be computed to test the hypotheses outlined above. To determine the best predictor of safer sex behaviors among female Veterans, stepwise hierarchical multiple logistic regression analyses will be conducted among these variables. The variables with the highest R-squared will be deemed most predictive of the behavior. The overall strength of the relationships will be determined by the R-squared value and whether or not the individual variables make a significant contribution to the predicted relationship. Assumptions of sample size, multicollinearity and singularity, normality, linearity, homoscedasticity and independence of residuals must be met in order to carry out relevant statistical functions. SDO scores of female Veterans with and without a history of abuse will be compared using Student’s independent t-tests. Further analyses will be conducted to compare the scores of groups of women in relation to measures such as the SSBQ to determine if there are any differences in their mean behavior scores. The test statistic will be the t-statisticwith a p-value <.05 with a moderate or higher effect size (.06 to .14 or higher based on Cohen’s d). Power analysis revealed that a sample size of at least 116 could yield significant results.
Results: Preliminary results (6 paper surveys) indicate that female Veterans between 33-55 years of age engage in both safer and high risk sexual behaviors (i.e. condom use always to unprotected anal sex and alcohol consumption prior to sex). Some also inferred that marriage confers safety. In terms of SDO, a small number appear to believe that certain groups are more equal than others and that certain groups should be kept in their place. It is not known if this belief influences sexual behavior as further analyses are needed.
See more of: Invited Posters