HIV-related sexual decisions made by African-American adolescents living in different family structures: study from an ecodevelopmental perspective

Figures & data

Table 1 Sixty survey items and associated Cronbach’s alpha values in each of four systems of the ecodevelopmental theory using Wave I Add Health

Systems	Variables (questions)	Cronbach’s alpha
Microsystem	School-level factors (12 questions)	0.89
	“Have you ever received an out-of-school suspension from school?”
	“Have you ever been expelled from school?”
	“How often did you have trouble: getting along with your teachers?”
	“How often did you have trouble: paying attention in school?”
	“How often did you have trouble: getting your homework done?”
	“How often did you have trouble: getting along with other students?”
	“You feel close to people at school.”
	“You feel like you are part of your school.”
	“Students at your school are prejudiced.”
	“You are happy to be at school.”
	“The teachers at your school treat students fairly.”
	“You feel safe in school.”
	Religion (2 questions)	0.89
	“In the past 12 months, how often did you attend religious services?”
	“How important is religion to you?”
	Peer knowledge (3 questions)	0.74
	“Your closest friends are quite knowledgeable about the withdrawal method of birth control.”
	“Your closest friends are quite knowledgeable about how to use a condom correctly.”
	“Your closest friends are quite knowledgeable about the rhythm method of birth control and when it is a ‘safe’ time during the month for a woman to have sex and not get pregnant.”
	Closeness with people in the neighborhood (4 questions)	0.63
	“People in this neighborhood look out for each other.”
	“Do you usually feel safe in your neighborhood?”
	“On the whole, how happy are you with living in your neighborhood?”
	“If, for any reason, you had to move from here to some other neighborhood, how happy or unhappy would you be?”
	Feeling love from the mother (4 questions)	0.94
	“Most of the time, your mother is warm and loving toward you.”
	“You are satisfied with the way your mother and you communicate with each other.”
	“How close do you feel to your mother?”
	“How much do you think your mother cares about you?”
	Feeling love from the father (4 questions)	0.98
	“Most of the time, your father is warm and loving toward you.”
	“You are satisfied with the way your father and you communicate with each other.”
	“How close do you feel to your father?”
	“How much do you think your father cares about you?”
	Condition of dwelling unit (1 question)	_
	Dwelling unit type (1 question)	_
	Condition of neighborhood buildings (1 question)	_
	Safety of living environment (1 question)	_
	Dominant land use of the immediate area (1 question)	_
Mesosystem	Mother’s involvement (5 questions)	0.81
	“On a scale of 1–5, where 1 is low and 5 is high, how disappointed would your mother be if you did not graduate from college?”
	“On a scale of 1–5, where 1 is low and 5 is high, how disappointed would your mother be if you did not graduate from high school?”
	“Gone to a religious service or church-related event with you mother in the past 4 weeks.”
	“Talked about your school work or grades with you mother in the past 4 weeks.”
	“Talked about other things you are doing in school with you mother in the past 4 weeks.”
	Father’s involvement (5 questions)	0.97
	“On a scale of 1–5, where 1 is low and 5 is high, how disappointed would your father be if you did not graduate from college?”
	“On a scale of 1–5, where 1 is low and 5 is high, how disappointed would your father be if you did not graduate from high school?”
	“Gone to a religious service or church-related event with you father in the past 4 weeks.”
	“Talked about your school work or grades with you father in the past 4 weeks.”
	“Talked about other things you are doing in school with you father in the past 4 weeks.”
	Mother’s attitude toward adolescent’s sexual behavior (2 questions)	0.92
	“How would your mother feel about your having sex at this time in your life?”
	“How would your mother feel about your use of a condom?”
	Father’s attitude toward adolescent’s sexual behavior (2 questions)	0.99
	“How would your father feel about your having sex at this time in your life?”
	“How would your father feel about your use of a condom?”
	Mother’s attitude toward adolescent’s birth control use (1 question)	_
	Father’s attitude toward adolescent’s birth control use (1 question)	_
Exosystem	Household income (1 question)	_
	Occupation of the mother (1 question)	_
	Occupation of the father (1 question)	_
Macrosystem	Mother received public assistance (1 question)	_
	Father received public assistance (1 question)	_
	Supplemental security income (1 question)	_
Outcomes	Adolescent’s age at initiation of sexual experience	_
	Adolescent had sexual experience by 16 years of age	_
	Adolescent used a condom at first sexual intercourse	_
	Adolescent used a condom at last sexual intercourse	_

Notes: “_” indicates only one question/item was used, and thus, no Cronbach’s alpha is reported. Questions were directly quoted from Add Health, In-Home Questionnaire for Public-Use Data. Data from Harris et al⁴⁰; Data from Harris and Richard Udry.⁴¹

Table 2 Demographic characteristics of African-American adolescents in Wave I of Add Health

Variable	N	Weighted frequency	Weighted percentage (SD)	x^2(df)	P-value
Age groups (years)				75.46 (2)	<0.0001
10–13	253	562,899	15.44 (3.46)
14–17	1,149	2,370,744	65.04 (2.06)
≥18	280	711,498	19.52 (2.67)
Gender				0.01 (1)	0.9363
Female	846	1,817,501	49.86 (1.74)
Male	771	1,827,639	50.14 (1.74)
Sexual orientation				818.29 (1)	<0.0001
Majority (heterosexual)	1,583	3,560,170	97.67 (0.50)
Minority (homosexual or bisexual)	34	84,970	2.33 (0.50)
Age at first sexual intercourse (years)				156.14 (3)	<0.0001
<10	152	369,481	10.14 (1.13)
10–15	509	1,258,876	34.54 (2.58)
16–20	176	393,246	10.79 (1.39)
Never had sexual intercourse	780	1,623,537	44.54 (2.92)
HIV test				560.64 (1)	<0.0001
Tested	141	366,360	10.09 (1.02)
Never tested	1,472	3,269,809	89.91 (1.02)
Numbers of sexually transmitted infection (STI)				450.09 (3)	<0.0001
More than one STI	18	40,852	1.12 (0.33)
Have one STI	62	157,312	4.31 (0.61)
No STI	756	1,822,171	49.91 (1.49)
Never had sexual intercourse	780	1,623,537	44.47 (1.44)
Condom use at first intercourse				35.30 (2)	<0.0001
Never had sexual intercourse	780	1,623,537	44.69 (2.92)
Used a condom	536	1,223,387	33.68 (2.36)
Not used a condom	294	785,743	21.63 (1.45)
Condom use at last intercourse				32.36 (2)	<0.0001
Never had sexual intercourse	780	1,623,537	45.04 (1.45)
Used a condom	518	1,184,020	32.85 (1.42)
Not used a condom	308	809,984	22.39 (1.84)
Giving sex in exchange for drugs or money				952.29 (1)	<0.0001
No	1,581	3,539,624	98.17 (0.42)
Yes	24	65,927	1.83 (0.42)
Biological mother				1028.10 (2)	<0.0001
Not known	26	74,572	2.05 (0.41)
Know	203	551,897	15.18 (1.32)
Living with biological mother	1,386	3,009,647	82.77 (1.40)
Biological father				137.80 (2)	<0.0001
Not known	194	501,515	13.82 (1.29)
Know	817	1,951,062	53.76 (1.73)
Living with biological father	602	1,176,562	32.42 (2.37)
Family structure of household				102.84 (2)	<0.0001
Both parents in the household‡	699	1,348,321	36.99 (2.59)
Single parent in the household‡	771	1,868,598	51.26 (2.85)
Other relatives or live alone	147	428,222	11.75 (1.22)
Know how to use a condom				783.58 (4)	<0.0001
Strongly disagree	45	101,273	2.89 (0.53)
Disagree	72	162,904	4.65 (0.66)
Neither agree nor disagree	108	221,942	6.34 (0.77)
Agree	560	1,267,897	36.19 (1.77)
Strongly agree	780	1,749,329	49.93 (2.33)

Notes: N=1,617 observations; Rao-Scott chi-square test was performed using design-adjusted, survey-weighted;

‡ residential parent(s): biological parent, adoptive parent, step-parent, foster parent, etc.

Table 3 Linear regression of age at first sexual intercourse of African-American adolescents in Wave I of Add Health

System	Outcome	All	Structure 1	Structure 2	Structure 3
Microsystem	School-level factors	0.05**	0.06	0.07***	0.02
	Friends had knowledge of sexual information	−0.12*	0.23	−0.11	−0.21*
	Feeling love from the mother	0.08	−0.23*	0.13	0.12*
	Feeling love from the father	0.06	0.02	−0.03	0.17*
	Dominant land use of immediate area (rural)	0.88	9.84****	1.30	−1.18
	Dominant land use of immediate area (suburban)	0.43	−0.66	0.36	0.21
	Building (detached single-family house)	0.32	−2.61*	0.43	−0.14
	Building (mobile home/trailer)	0.26	−3.20*	−0.08	0.17
	Building (single-family row/town house)	0.09	−1.66	−0.05	−0.78
	The condition of dwelling unit	0.21	1.55**	0.63*	−0.29
	Condition of neighborhood building	−0.45	−4.43***	−0.58	0.32
	Safety of living environment	0.83	4.46**	0.44	0.08
Mesosystem	Mother’s involvement	−0.02	0.44*	−0.04	0.14
	Mother’s attitude toward adolescent’s use of birth control	−0.36****	−0.44	−0.29*	−0.28*
	Mother’s attitude toward adolescent having sexual experience in teens	0.15	−0.19	0.16	0.33*
Exosystem	Household income	−0.00***	−0.00	−0.01	−0.00
	Mother’s occupation (none)	−0.54	−1.44	−0.94	−0.07
	Mother’s occupation (restaurant worker, personal service)	−0.68*	−2.74**	−0.55	−0.60
	Mother’s occupation (computer specialist, office worker)	−0.62	−2.27	−0.45	−0.95*
	Father’s occupation (none)	−0.52	−3.33	−2.19	−0.66
	Father’s occupation (restaurant worker, personal service)	−0.12	−2.31*	0.19	0.30
	Father’s occupation (computer specialist, office worker)	0.61	2.49	0.67	0.34
Macrosystem	Received supplemental security income	0.87	−3.47*	1.37*	−0.61
	Mother received public assistance	0.08	1.70	0.60	−0.95
	Father received public assistance	−0.63	0.55	0.91	0.17
Individual	Age	0.43***	0.26	0.42***	0.40**
	Sexual orientation (sexual majority)	2.33**	2.34	2.28**	0.10
	Knowledge about condom use	−0.28	−1.43**	−0.42	0.00
R square		0.150	0.69	0.18	0.17

Notes: Structure 1: adolescents lived with other relatives or lived alone; Structure 2: adolescents lived in a single-parent household; Structure 3: adolescents lived in a two-parent household. Sample sizes: Structure 1 (N=64), Structure 2 (N=505), Structure 3 (N=456), and all (N=1,025).

* P<0.05;

** P<0.01;

*** P<0.001;

**** P<0.0001.

Table 4 Logistic regression of African-American adolescents with sexual initiation prior to age of 16 years

System	Variables	All	Structure 1	Structure 2	Structure 3
Microsystem	School-level factors	0.96**	0.86	0.93**	1.00
	Significance of religion	1.01	0.58	0.97	1.17**
	Friends had knowledge of sexual information	1.05	0.56*	1.05	1.12*
	Feeling love from the mother	0.95*	1.26	0.88*	0.85*
	The condition of dwelling unit (very poorly kept vs. very well kept)	1.71	1.40	3.84*	1.66
	The condition of dwelling unit (poorly kept vs. very well kept)	1.06	71.81	1.35	0.92
	The condition of dwelling unit (fairly well kept vs. very well kept)	1.10	6.20	1.63	0.68
Mesosystem	Father’s involvement	1.12*	1.07	1.01	1.16
	Mother’s attitude toward adolescent having sexual experience in teens	0.84	0.42	0.84*	0.68***
	Father’s attitude toward adolescent having sexual experience in teens	0.95	0.63	0.11****	0.92
	Mother’s attitude toward adolescent’s use of birth control	1.31****	1.73	1.35**	1.15
Individual	Age	1.35****	2.36***	1.21**	1.59****
	Knowledge about condom use	1.73****	14.56****	1.99**	1.28
	Gender (female vs. male)	0.70*	1.53	0.61*	0.88
C statistic		0.81	0.92	0.81	0.83

Notes: Estimates are odds ratios. Target population was those who had sexual debut before the first interview of Add Health study. Structure 1: adolescents lived with other relatives or lived alone; Structure 2: adolescents lived in a single-parent household; Structure 3: adolescents lived in a two-parent household. Sample sizes: Structure 1 (N=147), Structure 2 (N=771), Structure 3 (N=699), and all (N=1,198).

* P<0.05;

** P<0.01;

*** P<0.001;

**** P<0.0001.

Table 5 Logistic regressions of African-American adolescents using a condom at first and last sexual intercourse

System	Variables	First sexual intercourse				Last sexual intercourse
		All	Structure 1	Structure 2	Structure 3	All	Structure 1	Structure 2	Structure 3
Microsystem	School-level factors	1.03**	1.07	1.03*	1.05*	1.01	1.11	1.02	0.94*
	Significance of religion	1.03	1.31	1.01	0.98	0.99	1.19	0.89*	1.20
	Friends had knowledge of sexual information	1.04	1.51	1.09	0.86	1.01	0.82	0.95	1.37***
	Feeling closeness with people in neighborhood	1.05	0.91	0.98	1.13	1.10*	1.15	1.06	1.18
	Feeling love from the father	1.03	1.68*	0.83	1.02	0.92	0.78	1.04	0.95
	Safety of living environment	0.75	0.23	1.29	0.16**	0.65	0.28	0.41	0.89
Mesosystem	Mother’s attitude toward adolescent having sexual experience in teens	0.97	1.11	0.86	1.45**	0.94	1.09	1.02	0.92
	Father’s attitude toward adolescent having sexual experience in teens	1.01	1.21	1.22	0.72*	1.01	1.21	0.78*	1.06
	Mother’s attitude toward adolescent’s birth control use	1.10	0.93	1.03	1.43	1.15	1.10	1.25*	1.29
	Father’s attitude toward adolescent’s birth control use	0.96	0.38	1.09	0.83	0.97	0.87	0.65**	0.90
Macrosystem	Received supplemental security income	1.12	4.62	0.75	4.50	0.81	0.39	0.62	14.16*
Individual	Age	1.01	0.70	0.89	1.20	0.86*	0.34**	0.88	0.95
	Knowledge about condom use	1.22	0.78	1.69**	0.86	1.29	0.79	1.75*	0.89
	Gender (female vs. male)	1.31	3.37	1.17	2.87*	0.75	0.74	0.66	0.83
C statistic		0.61	0.82	0.61	0.70	0.62	0.75	0.66	0.75

Notes: Estimates are odds ratios. Structure 1: adolescents lived with other relatives or lived alone; Structure 2: adolescents lived in a single-parent household; Structure 3: adolescents lived in a two-parent household; Sample sizes: Structure 1 (N=94), Structure 2 (N=426), Structure 3 (N=317), and all (N=625).

* P<0.05;

** P<0.01;

*** P<0.001.

Table 6 African-American adolescents’ condom use behavior at first and last sexual intercourse

Family structure	Used a condom at first sexual intercourse	Used a condom at last sexual intercourse	Percentage (SD)
Structure 1	No	No	24.33 (4.99)
	Yes	No	13.62 (3.50)
	No	Yes	19.69 (4.31)
	Yes	Yes	42.36 (5.79)
Structure 2	No	No	25.62 (2.68)
	Yes	No	18.64 (1.91)
	No	Yes	14.45 (2.52)
	Yes	Yes	41.29 (2.58)
Structure 3	No	No	21.23 (3.30)
	Yes	No	13.99 (2.74)
	No	Yes	12.34 (2.10)
	Yes	Yes	52.45 (3.42)

Notes: Structure 1: adolescents lived with other relatives or lived alone; Structure 2: adolescents lived in a single-parent household; Structure 3: adolescents lived in a two-parent household; all participants =837; Rao-Scott chi-square (df)=18.15(4); P-value =0.0012.

HarrisKMHalpernCTWhitselEThe National Longitudinal Study of Adolescent to Adult Health: Research Design2009 Available from: http://www.cpc.unc.edu/projects/addhealth/designAccessed February 20, 2018

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HarrisKMRichard UdryJNational Longitudinal Study of Adolescent Health (Add Health), 1994–2008 (Public use)Chapel Hill, NCCarolina Population Center, University of North Carolina-Chapel HillAnn ArborInter-university Consortium for Political and Social Research2014 Available from: https://www.icpsr.umich.edu/icpsrweb/ICPSR/studies/21600Accessed February 20, 2018

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