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Article Excerpt
In the United States, African American male adolescents are at significant risk of HIV infection. For instance, male African Americans between the ages of 14 and 24 years comprise approximately 16.8 percent of the adolescent population (U.S. Census Bureau, 2000), but they account for more than 55 percent of all new adolescent HIV infections (Centers for Disease Control and Prevention, 2006a). Consequently, more research is needed to obtain a clearer understanding of the factors associated with sexual risk behaviors within this group. Such research is critical if we are to develop culturally relevant approaches to curtailing the spread of HIV infection among African American male adolescents. Conspiracy theories in relation to health have long been present among some segments of the African American populace. According to Turner's (1993) classic study I Heard It Through the Grapevine: Rumor in African-American Culture, there is a distinction between malicious intent theories and benign neglect theories. Malicious intent theories refer to deliberate attempts by the government to "undermine" the African American population. An example would be the belief that AIDS was created by white America to eliminate the African American population (see Towns, 1995). As evidence, believers point to the disease's rapid spread in their community and the government's nonresponsiveness to African American health care needs (Parsons, Simmons, Shinhoster, & Kilburn, 1999), Benign neglect theories involve a government that does little to solve problems in the African American community because the well-being of African Americans is a low priority (Turner, 1993). A contemporary example of this theory, some would argue, is represented by Hurricane Katrina and the government's delayed and deplorably inadequate response to the disaster in New Orleans. It is believed that conspiracy beliefs stem from chronic experiences of discrimination (Bird & Bogart, 2005).
Some of these beliefs also have historical origins. For instance, the Tuskegee Experiment,in which African American men were deliberately left untreated for syphilis in the name of "science," has undermined trust in public health officials and spawned a number of prominent conspiracy theories. For reviews of conspiracy theories among African Americans, see Parsons et al. (1999).
However, only recently have studies examined the role of conspiracy theories about the origin of HIV and its relationship to sexual risk behaviors among African Americans. For example, Bogart and Thornburn (2005) in a random telephone sample of 500 African Americans between the ages of 15 and 44 found that 59 percent of the sample believed that significant information about AIDS is being held back from the public, 53 percent believed that a cure for AIDS was being withheld from the public, and 43 percent believed that the government was using people who take new medications as guinea pigs. For men--with sociodemographic variables, partner characteristics, sexually transmitted disease history, perception of risk, and psychological factors controlled for--stronger conspiracy beliefs were significantly associated with more negative condom attitudes and inconsistent condom usage (Bogart & Thornburn, 2005).
Another study using a community-based sample of 1,494 men and women (ages 18 to 50 and over) from four racial or ethnic groups (African American, Latino, non-Hispanic white, and Asian) found that the highest levels of belief in conspiracy theories (for example, AIDS being an agent of genocide created by the U.S. government to kill minority populations) were reported among women, African Americans, and Latinos. In addition, for African American men only, higher levels of belief in conspiracy theories were associated with lower rates of condom use (Ross, Essien, & Tortes, 2006).
Collectively, the earlier-mentioned studies have begun to document associations between conspiracy beliefs and low condom usage among male African Americans. However, additional research is warranted. Almost no research has examined the relationship between conspiracy beliefs and sexual risk among a cohort of solely African American male adolescents. This is unfortunate given that boys often have greater sexual decision-making power than girls in sexual encounters (Amaro, Fried, Cabral, & Zuckerman, 1990). Insights into factors influencing risk behaviors among boys may enable us to design more effective intervention programs, which may benefit boys and their sexual partners. In addition, prior researchers have focused on samples of male and female African Americans spanning wide age ranges (that is, 15 to 50 years and older) (Bogart &Thornburn, 2005; Ross et al., 2006). This is problematic, because conspiracy theories may have strong origins in generational cohorts at particular moments in history and may evolve over time. Also, gender differences are likely very significant. Furthermore, conspiracy theories may exist in conjunction with other social factors (for example, hopelessness among African American youths, media influences) that are perceived to have bearing on why rates of HIV infection may be especially high among specific vulnerable populations. Moreover, additional insights into such conspiracy beliefs may have important implications for culturally pertinent adolescent HIV intervention programs. Finally, according to the information-motivation-behavioral skills (IMB) model (Fisher & Fisher, 1992; Fisher, Fisher, Williams, & Malloy, 1994), access to accurate information is believed to have direct effects on adolescents' sexual behavior. Therefore, it is important to explore how accurate information versus conspiracy beliefs may be associated with sexual risk behaviors among African American male youths. More specifically, in this study we examined whether male youths who believe that their peers are becoming infected with HIV at higher rates than white youths are engaging in different sexual behaviors than are those who do not believe in such disparate rates.
Therefore, the purpose of the current study was to focus on one of the most vulnerable and underresearched groups--African American male adolescents--using a qualitative approach to generate knowledge that may prove important to the design of more effective culture- and gender-specific HIV prevention approaches.
METHOD
As part of a larger investigation into the relationship between community-level factors and HIV sexual risk behaviors among African American youths in a large urban area, we queried participants about their perception of the uneven rates of HIV infection among their...
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