Empowerment in prevention: a qualitative inquiry into Black girl-centred strategies for reducing HIV/STI and drug misuse risk

TL;DR

This study explores barriers to HIV/STI and drug prevention for Black girls in the U.S. and suggests tailored, peer-led programs to improve education and support.

Contribution

The study introduces Black girl-centred strategies for prevention programming based on direct input from the community.

Findings

Participants highlighted the lack of parent–child discussions on sex and STI/HIV education.

Schools were identified as environments with stigma that hinder access to accurate information.

Tailored prevention programs with peer-led discussions in small groups were suggested as more effective.

Abstract

Black girls in the United States are disproportionately diagnosed with sexually transmitted infections (STIs), which can increase the risk of contracting HIV (human immunodeficiency virus), compared to adolescent girls of other races. Therefore, this study was designed to understand barriers to impactful HIV/STI and substance use prevention programmes for Black girls. Data was collected between October 2021 and June 2022 from twelve focus groups which included (N = 62) participants who identified as Black and female between the ages of 13 and 18 years old. Using intersectionality theory as a guiding framework, the data were analysed thematically. The analysis revealed three themes: (1) need for parent–child discussions on sex; (2) stigma in schools; (3) suggestions for Black girl-centred prevention programming. Participants described minimal discussion about sex in their household as well as STI/HIV and substance abuse stigma as barriers to impactful sex education. They also indicated that current substance use and STI/HIV prevention interventions are not tailored to the experience of Black girls and offered suggestions for improvement. In sum, participants pointed out several barriers to existing sex education and substance abuse prevention programmes. Findings revealed that HIV and drug use prevention information and knowledge may be best received from older peers in small private settings that can allow for intimate discussion and sharing of reliable information on HIV education, aetiology, and safer sexual practices. In addition, the study findings support the need to develop a racial and gender-specific prevention programming that fosters peer relationships, social support, and empowerment-based principles.

Black girls in the United States face a higher risk of sexually transmitted infections (STIs), including HIV, compared to girls of other races. This study aimed to explore the barriers that make it difficult for HIV/STI and substance use prevention programmes to effectively reach and help Black girls. We conducted twelve focus groups with 62 Black girls aged 13–18 to gather their thoughts and experiences. We used intersectionality theory to understand how different aspects of their identities, like race and gender, affect their lives and access to health information.

The study revealed three key findings:

Need for Parent–Child Conversations:
Many girls felt that their parents did not talk to them enough about sex, which left them uninformed.Stigma in Schools:
The girls reported that stigma around HIV, STIs, and substance use in schools made it harder for them to access accurate information and support.Better Programmes for Black Girls:
The girls suggested that current prevention programmes are not designed with their unique experiences in mind. They want programmes that are more tailored to their needs, with opportunities for open discussions in small groups led by older peers.

Need for Parent–Child Conversations:
Many girls felt that their parents did not talk to them enough about sex, which left them uninformed.

Stigma in Schools:
The girls reported that stigma around HIV, STIs, and substance use in schools made it harder for them to access accurate information and support.

Better Programmes for Black Girls:
The girls suggested that current prevention programmes are not designed with their unique experiences in mind. They want programmes that are more tailored to their needs, with opportunities for open discussions in small groups led by older peers.

In conclusion, this study highlights the importance of creating prevention programmes specifically for Black girls. These programmes should encourage peer support, empower the girls, and provide safe spaces for them to learn and talk about HIV, STIs, and substance use.