Date of Conferral





Public Health


Wen-Hung Kup


There is a high HIV prevalence rate for Black women in Virginia; however, few scholars have examined how sexual assertiveness and self-esteem against HIV vary within this group. Black women who have low levels of self-esteem may increase their risk for HIV. The purpose of this quantitative cross-sectional study was to determine if four aspects of sexual assertiveness (sexual initiation, sexual refusal, HIV/AIDS/STD communication, and contraception/STD prevention) differed across demographic categories and were associated with self-esteem in a diversified group of Black women living in Virginia. A cross-sectional survey was conducted with a community-based sample of 117 adult Black women. The social cognitive theory was the framework that guided this study. ANOVAs were used to determine differences in means of the four sexual assertiveness subscales across the demographic categories (age, sexual orientation, income, education, and relationship status. HIV, AIDS, and sexual transmitted disease communication assertiveness mean scores were significantly higher among higher income Black women (padj=.016) and Black women with a college versus a high school degree (padj=.047). Moreover, Pearson bivariate correlation results showed self-esteem was significantly positively associated with all but one measure (sexual initiation) of sexual assertiveness. Health educators can use the findings of this study to create education initiatives that focus on building self-esteem and sexual assertiveness behaviors among Black women as an HIV/AIDS prevention method.