Gendered powerlessness in at-risk adolescent and young women: an empirical model

• Published in: AIDS care 2020-10, Vol.32 (10), p.1333-1342
• Main Authors: Chiaramonte, Danielle, Miller, Robin Lin, Lee, KyungSook, Santiago Rivera, Olga J., Acevedo-Polakovich, Ignacio D., McGirr, Sara, Porter, Jennifer L., Ellen, Jonathan M., Boyer, Cherrie B.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent and young women; Adolescents; Adult; AIDS/HIV; Alienation; At risk populations; Bayes Theorem; Cathexis; condom use; Condoms; Connell's theory of gender and power; Disease control; Empirical analysis; Factor analysis; Female; Gender; gendered power imbalance; Health behavior; Heterosexuality; High risk; HIV; HIV Infections; Human immunodeficiency virus; Humans; HyperText Markup Language; Infections; Multivariate statistical analysis; Politics; Power; Power, Psychological; Prevention; Preventive medicine; Privacy; Risk; Sexual and Gender Minorities; Sexual Behavior; Sexual Partners; Sexually transmitted diseases; STD; Teenagers; Womens health; Young Adult; Young women; Youth
• ISSN: 0954-0121; 1360-0451
• DOI: 10.1080/09540121.2020.1724252

In the United States, youth aged 13-24 comprised approximately 21% of new HIV infections in 2017; 13% of these infections occurred among women, the majority of whom (86%) acquired HIV through heterosexual contact (Centers for Disease Control and Prevention. 2019a . HIV and youth. Retrieved from https://www.cdc.gov/hiv/group/age/youth/index.html , Centers for Disease Control and Prevention. 2019b . HIV among women. Retrieved from https://www.cdc.gov/hiv/group/gender/women/index.html). We fit and validated a developmentally appropriate empirical model of Connell's Theory of Gender and Power (Connell, R. W. 1987. Gender and power: Society, the person and sexual politics. Stanford, CA: Stanford University Press, Connell, R. W. 2013. Gender and power: Society, the person and sexual politics. Hoboken, NJ: John Wiley & Sons) in a sample of young women and assessed whether gendered powerlessness reflected a multidimensional higher-order latent factor, as the theory implies. Anonymous computer-assisted interviews were administered to at-risk, sexually active young women (N = 1,101). Factor analyses and structural equation modeling were used to determine the dimensionality of gendered powerlessness. Associations with condom use were examined to validate the model. We fit a three-component model of gendered powerlessness, but not a higher-order latent factor. We observed that high scores on two dimensions of gendered powerlessness - cathexis and sexual division of power - were associated with lower likelihood of condom use. Our three-component model helps elucidate the role that components of gendered powerlessness play in young women's health behaviors and underscores the need for measures tailored to young women at high risk of contracting HIV.