Exploring gender norms and relation to condom and contraceptive use attitudes among adolescent girls in low-resource neighborhoods

Purpose: A growing body of evidence supports an important role for promotion of gender equality in sexual and reproductive health ed-ucation. Previous research has demonstrated that programs that address gender and power are far more likely to reduce STI or preg-nancy than those that do not. However, there is a paucity of evidence regarding the correlation between gender equitable attitudes specifically and positive sexual and reproductive health outcomes. Additionally, research on gender norms and behaviors among boys and men is more extensive. Far less is known about the role of gender equitable attitudes among adolescent girls and the impact on sexual decision-making and behaviors. In this study, we hypothesize that gender equitable attitudes and positive attitudes toward women among adolescent girls are associated with greater condom and con-traceptive self-efficacy and attitudes. Methods: Adolescent girls ages 13-19 are enrolling in an ongoing trial comparing a sexual violence prevention program to a job skills program. To date, 55 girls have enrolled from four low-resource neighborhoods which are predominantly African American. Prior to program implementation, participants complete a baseline survey that includes measures on gender norms and sexual health self-efficacy and attitudes. All measures use response options on a 1-5 scale (e.g., “strongly agree” to “strongly disagree”), except for attitudes towards women (1-4 scale); higher scores reflect more positive views (e.g., more equitable gender attitudes). Mean scores were calculated for each measure. Unadjusted and adjusted linear regression models tested associations between the gender role measures and sexual health self-efficacy and attitudes. Results: Mean scores were calculated for gender equitable attitudes (3.8, SD.46), attitudes toward women (3.2,.41), condom self-efficacy (4.0,.77), contraceptive self-efficacy (3.7, 1.16), and condom and contraceptive attitudes (3.3,.38). More positive gender equitable attitudes and attitudes toward women were associated with increased condom self-efficacy (adjusted =.59 95% CI.20-.98, and =.49 [.01-.98], respectively). Gender equitable attitudes and attitudes towards women were not significantly associated with contraceptive self-efficacy (adjusted β =.43 [-.29, 1.15] and β =.34 [-.51, 1.18], respectively) or condom and contraceptive attitudes (adjusted β=-.01 [-.25,.23] and β=-.01 [-.29,.27], respectively). Conclusions: These early findings suggest that gender norms may be associated with condom negotiation self-efficacy for adolescent girls. Further study of the relationship of gender attitudes with sexual health behaviors for girls could inform sexual health promotion and sexual violence prevention efforts. There is potential to modify such gender attitudes through intentional development of critical think-ing related to gender as well as intersections with race and class as part of comprehensive sexual health education. Sources of Support: The Grable Foundation and FISA Foundation.