Addressing sexually transmitted infections in the sociocultural context of black heterosexual relationships in the United States.

Rationale: Black girls and women are disproportionately affected by sexually transmitted infections (STIs) and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). Research shows sexual networks, sexual concurrency, and assortative mixing impacting racial disparities in STI/HIV. However, the underlying sociocultural conditions of these phenomenon have yet to be fully explored within a framework of Black girls' and women's sexual development. Objective: This grounded theory study investigated the sociocultural conditions and processes of becoming a sexual Black woman in order to understand the sociocultural drivers of STI/HIV rates among this group. Method: We used theoretical sampling to select and interview 20 Black women aged 19-62 years old from a Midwestern community. Results: This study revealed sociocultural conditions related to Black heterosexual relationships and STI/HIV risk. Protecting Black men, silencing Black girls and women, cultural norms and messaging about sexuality, and gendered societal expectations and sexual stereotypes contribute to STI/HIV risk in Black girls and women. Conclusions: Our findings demonstrate how the intersection of social and systemic structures (i.e.,history, incarceration, unemployment) shape the context of Black heterosexual relationships. We suggest STI/HIV prevention efforts address these systemic, cultural, and societal factors in order to effectively reduce racial disparities in STI/HIV risk.