- Historically Black Colleges and Universities' Campus Culture and HIV Prevention Attitudes and Perceptions Among Students
African Americans continue to be impacted disproportionately by HIV/AIDS. In 2006, African Americans comprised 13% of the United States population, yet they accounted for 45% of new HIV/AIDS diagnoses (Centers for Disease Control and Prevention [CDC], 2008) and the HIV incidence rate was seven times as high for African Americans as for Whites (Hall et al., 2008). AIDS is the leading cause of death among African American women ages 25 to 34, and men ages 25 to 44 (CDC, 2007). Because of the latency period of HIV, many young adults with AIDS may have contracted HIV during adolescence (CDC, 1992). Recent data indicate that HIV is increasing among all adolescents ages 13 to 19 (CDC, 2006). However, African American adolescents account for nearly 70% of all HIV infections among this age group (CDC, 2006). In addition, 57% of the HIV/ AIDS diagnoses among older adolescents ages 20 to 24 were in African Americans (CDC, 2006).
In 2005, nearly 39% of U.S. adolescents ages 18 to 24 were enrolled in U.S. colleges and universities, and African Americans comprised 13% of students enrolled in college (National Center for Educational Statistics, 2008). Research suggests that many college students are engaging in risky sexual behaviors such as inconsistent condom use, use of drugs and alcohol during sex, sex with multiple partners (Brown, 2000; Gullette & Lyons, 2006; Opt & Laffredo, 2004; Klein, Geaghan, & MacDonald, 2007), and inadequate safe-sex communication with sexual partners (Freimuth, Hammond, Edgar, McDonald, & Fink, 1992; Thompson-Robinson, et al., 2005), which place them at increased risk for HIV infection. It is likely that some adults with HIV were infected during their college matriculation (Burns & Dillon, 2005). This information is especially pertinent to African American male college students who are disproportionately impacted by HIV infection compared with their nonminority peers (Hightow et al., 2005).
Based on these data, students attending historically Black colleges and universities (HBCUs) warrant special attention when addressing the HIV/AIDS health disparity. Taking into account that African American adolescents are disproportionately impacted by HIV/AIDS, that HBCUs grant 28% of all bachelor's degrees earned by African Americans (U.S. Department of Education, 2004) and that HBCUs have historically produced the majority of the Black leadership pool (Boyd, 2007), HBCUs have the potential to facilitate HIV risk reduction strategies among the campus community and to the broader African American community. [End Page 740]
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Currently, there are 103 public, private, 4-year, and 2-year HBCUs in the United States (U.S. Department of Education, 2007). HBCUs were founded upon, and continue to be united by, the distinct mission of positioning, preparing, and empowering African American students to succeed in what many perceive to be a lack of equity in advancement opportunities for African Americans as compared with Whites (Brown, Donahoo, & Bertrand, 2001).
Numerous studies conducted among HBCU students suggest that they may be engaging in sexual behaviors that place them at increased risk of HIV infection, while simultaneously believing that they are not at risk (Bazargan, Kelly, Stein, Husaini, & Bazargan, 2000; Duncan et al., 2002; Payne et al., 2006; Thompson-Robinson et al., 2005). Studies (Przybyla, White, & Goflin, 2007; Ferguson, Quinn, Eng, & Sandelowski, 2006) further identify that the gender ratio imbalance of more women to men on college campuses may contribute to a gender power imbalance, where women may unknowingly or knowingly engage in a sexual relationship with a man who is having sexual relationships with multiple women simultaneously. Studies suggest that sexual network size can have a significant impact on HIV acquisition and transmission (Adimora, Schoenbach, & Doherty, 2007; Hightow et al., 2005).
This study aims to fill a critical gap in the literature by examining how sociostructural factors present on HBCU campuses may impact the sexual decision making and HIV protective strategies of students. The purpose of this study was twofold: (1) To assess students' perspectives regarding the sociostructural HIV risk and protective...