Patterns of risk behavior change from adolescence to emerging adulthood: Implications for HIV/STD racial disparities

Abstract

Our previous studies documented large racial disparities in sexually transmitted infections (STI) between Black and White young adults. In this chapter, we apply a longitudinal person-centered analysis of sex and drug use behavior to examine whether infection among young adults varies by the trajectory of such behaviors over time. Findings suggest Whites were more likely to increase their risk behavior or persist in high risk behavior over time while Blacks (and especially Black women) were more likely to continue in stable low risk patterns or decrease their risk behavior over time. Nevertheless, Black men and women were much more likely than White men and women to have a positive STI/HIV test in young adulthood across all trajectories. These findings confirm conclusions that the current prevention paradigm, to reduce personal risk behavior and increase personal protective behavior (condom use), does not seem adequate for racial STD/HIV disparities. Structural and contextual factors may provide better clues to address the problem.