Graduation Year

2012

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Nursing

Major Professor

Maureen Groer, PhD

Committee Member

Jason Beckstead, PhD

Committee Member

Cecilia Jevitt, PhD

Committee Member

Wendy Nembhard, PhD

Keywords

Allostatic Load, Coping, John Henryism, Perceived Racism, Perceived Stress, Racial Discrimination

Abstract

Bacterial Vaginosis is an inbalance of vaginal flora which has been associated with increased risk of numerous gynecological and obstetric morbidities including increased risk of acquisition of HIV from an infected partner and increased risk of preterm delivery. Black race has been consistently identified as a risk factor for BV. Black women also suffer from significant disparities in most of the morbidities also associated with BV when compared to women of other ethnicities and races. Traditional predictors of BV such as douching practices and sexual behaviors do not fully account for the racial disparities in BV prevalence. Researchers have begun to explore the potential relationship between stress and BV. Also, perceived racism has been identified as a potential stressor contributing to the health outcomes of Black women.

The purpose of this study was to test a predictive model of bacterial vaginosis among Black women. The Allostatic Load Model was the theoretical framework. Participants (N=94) completed a self administered questionnaire and interview including measures of perceived stress, preceived racism, behavioral responses to stress and specific behavioral responses to racism along with traditional predictors of BV. Measurement scales included the Cohen Perceived Stress Scale, the John Henryism Scale of Active Coping, the Everyday Perceived Racial Discrimination Index, the Experiences of Discrimination Scale and the Vines Telephone Administered Perceived Racism Scale (TPRS) which included a behavioral responses to racism subscale. Bacterial vaginosis was diagnosed utilizing a self-collected vaginal swab which was analyzed utilizing the BVBlue point of care testing kit.

Twenty percent (N=19) of participants screened positive for bacterial vaginosis. Douching and sexual activity in the last three months and education were significantly associated with bacterial vaginosis. Age, income, hormonal contraceptive use and condom use were not associated with BV. Neither perceived stress nor perceived racism were associated with bacterial vaginosis. After logistic regression analysis, only education continued to be a significant predictor of BV.

The lack of an association between BV and the main study variables may have been related to young age of the sample or the low rates of high perceived stress and high perceived racism. Perceived stress was positively associated with perceived racism and behavioral responses to stress. This association is likely a reflection of the stressful nature of perceived racism. Further research is needed to better understand how the stressful nature of racism and behavioral responses to stressors may influence health outcomes and if interventions can be utilized to promote adaptive behavioral responses.

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