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. Author manuscript; available in PMC: 2021 Oct 5.
Published in final edited form as: Health Educ Behav. 2021 Jun;48(3):295–305. doi: 10.1177/10901981211010086

Race-Based Sexual Stereotypes, Gendered Racism, and Sexual Decision Making Among Young Black Cisgender Women

Keosha T Bond 1,2,3, Natalie M Leblanc 2,4, Porche Williams 5, Cora-Ann Gabriel 3, Ndidiamaka N Amutah-Onukagha 2,6
PMCID: PMC8491461  NIHMSID: NIHMS1743167  PMID: 34080468

Abstract

Background.

Due to their intersecting racial identity and gender identity, Black women are characterized by stigmatizing race-based sexual stereotypes (RBSS) that may contribute to persistent, disproportionately high rates of adverse sexual and reproductive health outcomes. RBSS are sociocognitive structures that shape Black women’s social behavior including their sexual scripts.

Objective.

The purpose of this study was to explore the influence of RBSS on the sexual decision making of young Black women (YBW).

Methods.

We conducted four focus groups with 26 YBW between the ages of 18 and 25, living in a New York City neighborhood with a high HIV prevalence. Qualitative analysis was used to identify emergent themes within the domains of sexual decision making as it relates to safer sex practices and partner selection.

Results.

Thematic analyses revealed that RBSS may cause women to adopt more traditional gender stereotypes and less likely to feel empowered in the sexual decision making. Participants reported that RBSS may lead Black women to being resistant to learning new information about safer sex practices, feeling less empowered within intimate relationships, and jeopardizing their sexual well-being to affirm themselves in other social areas encouraging unprotected sex and relationships with men who have multiple sex partners.

Discussion and Conclusion.

Future research should focus on understanding the social and cultural factors that influence Black women’s power in maintaining and improving their sexual health, including the aforementioned stereotypes that have influenced how others may view them as well as how they view themselves.

Keywords: African American, gender, qualitative methods, sexual behavior, women’s health

In American culture, Black women have navigated their lives through an intersectional lens (Collins, 2004; Crenshaw, 1990) that has been inadequately addressed in sexual and reproductive health (Kusunoki et al., 2016; Sangaramoorthy et al., 2017; Wyatt, 2009). Black women’s sexuality has been categorized by racialized, patriarchal, cultural sexual scripts that stem from historical oppression and subsequent stereotypes of Black women (French & Neville, 2013; Stephens & Phillips, 2003). Black women’s sexualities are characterized by stigmatizing race-based sexual stereotypes (RBSS), which have historical context but continues to develop and reinvent itself in contemporary times while contributing to the disproportionately high rates of adverse sexual and reproductive health outcomes such as high prevalence of HIV and other sexually transmitted infections (STIs; Collins, 2004; Newsome et al., 2018). Black women have a historical, disproportionate vulnerability to HIV and continue to have the highest rate of new infections among women (Centers for Disease Control and Prevention, 2019). While it has been well documented that racism, HIV stigma, and imbalanced relationship dynamics can negatively impact risk-taking behaviors and Black women’s engagement in the HIV neutral care continuum services, there is paucity of research on how sexualized stereotypes impact Black women’s health outcomes (Cheeseborough et al., 2020). Due to the fact that heterosexual transmission has been the primary mode of HIV transmission among Black women (92%; Centers for Disease Control and Prevention, 2019), it is essential to investigate the emotional, historical, and sociocultural influences that foster condomless sex (Paxton et al., 2013) and barriers to utilization of pre- and postexposure prophylaxis (Bond et al., 2021; Bond & Ramos, 2019).

Race-based sexual stereotypes are defined as implicit beliefs and expectations of sexual encounters that are dependent on the partner’s race/ethnicity (Wilson et al., 2009). This definition is drawn from the work of Ashmore and Del Boca (1979), which defined sex stereotypes as sociocognitive structures learned to through cultural socialization that shape sexual behavior. Wilson et al. (2009) expanded this concept to include race to explore the influence of racialized gender discourses and controlling images of sexual minority men based on their race and ethnicity. Few studies exploring stereotypes recognize historically grouped stereotypes, particularly among marginalized groups such as Black women (Ghavami & Peplau, 2013; Purdie-Vaughns & Eibach, 2008). Stereotypical archetypes that has been used in the past include mammy (a southern slang term for a Black woman who were considered the portly, asexual, and fierce caretakers), jezebel (a concept revolving around Black women who were often portrayed as innately promiscuous, even predatory), and sapphire (Black women who are portrayed as rude, loud, malicious, stubborn, and overbearing; West, 1995). Each stereotype has negatively affected the depiction of Black women in society (West, 1995). Black women have been inappropriately branded with mutually, inconsistent stereotypes in American culture (Flowers, 2018). The manner in which Black women are sexually objectivized and presented as hypersexual (Jezebel, Thot) and lazy (Welfare Queen) are prominent stereotypes that originated during slavery in the United States and continues in modern society (Collins, 2004; Prather et al., 2018). Conversely, Black women have also been inappropriately branded as emasculating (Sapphire, Matriarch) and a self-sacrificing, asexual (Mammy, Superwoman; Stephens & Phillips, 2003). Each stereotype has negatively affected the depiction of Black women in society and has been assimilated into the Black culture, to the point that these stereotypes have been internalized by Black women in shaping how they view their own sexuality and overall identity (Davis & Tucker-Brown, 2013; Teitelman et al., 2009).

Previous research has shown that there is a connection between internalization of negative stereotypes, low self-esteem, and engaging in risky sexual behaviors among Black women (Peterson et al., 2007; Prather et al., 2016; Thomas et al., 2004). Repeated social stigma can be internalized, and therefore challenge Black women’s efforts toward fostering healthy relationships with their sex partner(s) (Campos et al., 2016; Davis & Tucker-Brown, 2013; Pahl et al., 2020). These negative social stereotypes and depictions of such stereotypes create a discourse around Black women’s sexuality which normalize sexual scripts threatening sexual health decision making (Fritz et al., 2020; Townsend et al., 2010). It is essential to explore the influence of these stereotypes, and the wide variety of consequences they have for how Black women are viewed and treated in society in order to address the stigma that Black women face as it pertains to their sexual and reproductive health (Rosenthal & Lobel, 2016). Therefore, while researching the effects these conceptions have on the sexual health and wellness of young Black women, researchers must examine the environment in which they reside in; the colloquialisms, attitudes, and knowledge regarding RBSS. This inquiry is important in order to create solutions and develop culturally informed strategies toward sexual health and wellness (Davis & Tucker-Brown, 2013).

Theoretical Framework

An integrated framework(s) approach guided this article and included the integration of Black Feminist Thought, which centers U.S. Black women’s experiences with race-based stereotypes (Collins, 1989, 2002), and Sexual Script Theory (Simon & Gagnon, 1986), which illustrates ways in that “sexuality socialization, messages, and meanings are internalized and are manifested through sexual scripts” (Stephens & Phillips, 2005, p. 37). Black feminist thought, a U.S. Black women’s critical social theory, uses an intersectional lens to reflect on all Black women’s social location and validates Black women experiences in the creation of knowledge (Collins, 2002). American society has created a devalued and diminished perception of Black women in the United States in the form of race-based stereotypes (Collins, 2002; Crenshaw, 1990) creating barriers toward healthy autonomous sexual expression, which also manifests in other aspects of their lives and efforts to attain overall health and wellness (Davis & Tucker-Brown, 2013; Lambert et al., 2018; see Table 1 for race-based stereotypes definitions).

Table 1.

Definitions of Race-Based Stereotypes of Black Women.

Race-based stereotypes Definitions Implications
Historical
 Mammy The archetype of the portly, asexual and fierce caretaker, reinforced the absurdity that Black women will bear any burden, not because they wanted to, but because they were living for it. She is the woman who typically sacrifices her own needs to benefit someone else (Thomas et al., 2004). Internalization of this stereotype may lead to the need to be nurturing and supportive of others, often at one’s own expense, while presenting a façade of strength (West, 1995).
 Jezebel This archetype is the image of an immoral, sexually promiscuous, and sexually available Black woman. The stereotype of Jezebel was derived from the sexual exploitation and victimization of Black women, often as a way to justify sexual relations with enslaved women (Collins, 2004). Black women, seen in this role, are often viewed as promiscuous, loose, immoral, sexual aggressors, and lacking sexual restraint. Internalization of this stereotype may lead women to perceive sexuality as one of few assets or may cause sexual acting out or repression of sexual feelings (West, 1995).
 Sapphire This archetype is the image of an aggressive, dominating, angry, emasculating Black woman. The perceptions of Black women from this character include arrogance, being controlling, loud, hostile, obnoxious, and never satisfied (West, 1995). She represents the type of woman who has keen yet sarcastic wit and in some instances is quite abrasive. Her role is one of a “tough as nails” persona, one who is not easily shaken emotionally (Thomas et al., 2004). Internalization of this stereotype may lead women to perceive sexuality as one of few assets or may cause sexual acting out or repression of sexual feeling (West, 1995).
Contemporary
 Matriarch This archetype is linked to the Black women being the head of the household as the greatest threat to the Black community. Unquestioning belief in that assessment means single Black mothers and their children are demonized (Collins, 2002). Internalized of this stereotype may lead women to feel demonized for not having a traditional nuclear family and accepting of relationships that are unhealthy with unequal relationship dynamics.
 Angry Black Woman A variant of the Sapphire stereotype. This stereotype characterizes black women as bad-tempered, hostile, overly aggressive, and ignorant without provocation (West, 1995). Internalized of this stereotype may lead women to feel shame about challenging social inequalities and advocating for fair treatment due to fear of scrutiny and social rejection.
 Welfare Queen This archetype is connected to images of Black women as “breeders” dating back to slavery (Collins, 2002). The welfare queen is an image of an uneducated, poor, single Black woman who does not want to work but has many children in order to take advantage of public assistance (Woodard & Mastin, 2005). Internalized of this stereotype may lead women to feel demonized for not having a traditional nuclear family and accepting of relationships that are unhealthy with unequal relationship dynamics.
 Superwoman This archetype is linked to the pressure and expectation of Black women to manage multiple roles of the both homemaker and career women that usually inclusive to one person or gender. This mold of being self-reliant and self-contained is damaging in a sense because if you are unable to be self-reliant (i.e., needing extra help with the electric bill) and/or self-contained (i.e., feeling overwhelmed by the extra workload but being proud of being trusted to perform well under pressure) then culturally you aren’t a true strong Black woman and you aren’t to be depended on. Internalization of this stereotype may lead to the need to be nurturing and supportive of others while also trying to balance other aspects of their lives, often at one’s own expense, while presenting a façade of strength (West, 1995). This may lead a woman to neglect her own mental and physical health to obtain goals that are not realistic.
Thot This archetype is linked to Black women who are considered to have many casual sexual encounters or relationships (Glass, 2018). It is an acronym for the term “that hoe over there” and “thirsty hoes out there.” They are considered to be women who pretends to be the type of valuable female commodity who rightfully earns male commitment—until the man discovers that she’s just a cheap imitation of a “good girl” who is good only for mindless sex, not relationships or respect.” Internalization of this stereotype may lead women to perceive sexuality as one of few assets that would lead to acceptance by male sex partners.
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Combining Black feminist thought with sexual scripting constructs a culturally specific conceptual framework to examine the impact of stereotypes on the sexuality of Black women and how they contribute to the creation and understanding of norms regarding relationships and sexual behavior (Stephens & Phillips, 2005). The main concept that drives the sexual script theory is that sexuality, like race, is socially constructed (Gagnon & Simon, 1973). Sexual scripts aim to explain how people perceive sexual activity in conjunction with powerful historical and cultural forces that shape social life (Simon & Gagnon, 1986), which could lead to either protective or risky behavior related to their sexuality (see Figure 1; Hussen et al., 2012).

Figure 1.

Figure 1.

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A conceptual model of intersectional sexual scripts relate to HIV vulnerability.

These behaviors are influenced at three levels: cultural scenarios (dictate normative sexual behavior), interpersonal scripts (connect cultural scenarios to the individual experience), and intrapsychic scripts (internalized norms that influence the ways that individuals interpret and attach meanings; Simon & Gagnon, 1986). Formative sexual scripts can embody and reinforce RBSS (Wilson et al., 2009), since they are absorbed through cultural socialization processes and adapted, modernized, or enhanced through patterns of interpersonal social and sexual activity and personal belief systems (Whittier & Melendez, 2004). The focus of this article goes beyond documenting whether people are aware of current stereotyping of Black women. This article seeks to examine whether stereotypes about Black women influence their perception of themselves and whether stereotyping is generally extended to sexual health decisions including partnering and safer sex practices.

Methods

Participants

Focus group participants were recruited (July 2016 to October 2017) from two community-based organizations (CBOs) located in Brooklyn, New York, that provided sexual health services to the adolescent female population (13–25). The CBO setting was used because it was convenient and resource-efficient for the investigators. Women who were interested in participating were asked to complete an online screener or call the study telephone number to obtain more information. Potential focus group participants spoke with a member of the study team who explained the purpose of the focus group and administered a brief set of questions to determine participants’ eligibility. Based on their responses to these questions, the women were invited to attend a CBO-specific focus group in their area. To be eligible for the study, participants had to meet the following criteria: (1) 18 to 25 years old; (2) self-identified as heterosexual; (3) self-identify as African American, Black, Caribbean Black, or multiethnic Black; (4) self-reported negative or unknown HIV status; (5) reported oral, vaginal, or anal sex with a man in the past 12 months; (6) and reside in New York City. The final sample included 26 women who consented and engaged in all research activities.

Procedures

All study activities were conducted in English by trained research staff in a private space. After screening for eligibility into the study, participants underwent a detailed verbal informed consent process before data collection commenced. Participants completed a brief assessment survey which consisted of validated measures to assess women’s initial knowledge of HIV transmission, pre-exposure prophylaxis (PrEP), sexual behaviors, relationship dynamics self-efficacy, and HIV stigma administered via paper or tablet. Four focus groups of six to seven women each (N = 26), were approximately 2 hours, conducted in English at the CBO location, audio-recorded, and co-led by the principal investigator and a trained research associate. Focus group discussions were conducted using a standardized protocol (i.e., list of open-ended questions), and additional follow-up questions were asked when clarification was needed. Participants were compensated $45 and round-trip public transportation for the completion of the study. The preserved confidentiality data were de-identified, stored in a secured location, and securely transferred electronically to investigators involved in the analysis. All procedures were reviewed and approved by the Institutional Review Board (IRB-FY2017-408).

This article is centered on the section of the focus group discussion that addressed racial identity, womanhood, and sexual partnering behaviors (Table 2).

Table 2.

Focus Group Guide.

Topic Representative questions
Identity In terms of the U.S. way of categorizing race and ethnicity, how would you categorize yourself?
What does it mean to you to be an African-American or Black woman?
Relationship Dynamics What experiences, both positive and negative, do you think that African American or Black women have that most affect their sexual relationships?
Sexual Behavior In what ways do you think these experiences affect how African American or Black women have sex?
How do African American or Black women protect themselves from HIV? What strategies do they use?
What things encourage or motivate Black women to protect themselves from HIV? What encourages safer se practices?
What are the things that make it most difficult for African American/Black women and men—to protect themselves from HIV? More specifically, what are some of the things that encourage unsafe sex among African American women?
Perspectives of Safer Sex Practices What are the things that motivate people to protect themselves from HIV?
Are there some parts of the African American community, men or women, young or old, who are at higher risk of getting HIV? If so, why do you think that is?
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The questions used to derive data for this analysis represent one third of those asked in the full focus group guide that reflected on personal, social, and cultural factors that impact attitudes toward PrEP (e.g., sexual risk and protective behaviors, sexual partners, attitudes toward HIV medications, stigma) using a Black feminist thought lens. Therefore, the data used in this analysis focus primarily on the participants’ sexual experiences tied to their gender, race, and sexuality (i.e., beliefs and perceptions about Black women with their sexual partners, community, and society). This integrated framework uses sexual script theory to structure these sexual messages, while Black feminist thought concentrates on the meanings and values given to the messages (Stephens & Phillips, 2005).

Analysis

Descriptive statistics were analyzed for the focus group participants using IBM SPSS Statistics 26 (IBM Corp., 2019). The focus group recordings were transcribed and transcriptions were reviewed for accuracy, imported into Dedoose software (Dedoose Version 8.0.35, 2018) for coding and analysis using themes informed by an intersectional framework, Black feminist thought, and sexual script theory (Stephens & Phillips, 2005). The codes were identified by the two leading researchers and the research associate, qualified in qualitative approaches, using a multilayer approach focused on the topics covered by the focus group guide. Qualitative analysis occurred in multiple stages, using an inductive approach of open coding and axial coding used in grounded theory (Patton, 1990; Strauss & Corbin, 1997). The researcher merged similar codes, resolved coding discrepancies, and established inter-coder reliability for the final codebook. The authors of this article used an iterative process of fitting data and theories to interpret data through the lens of the theoretical framework (Timmermans & Tavory, 2012). To ensure the themes portrayed data in a coherent manner, the coders worked individually to define codes. The descriptions of RBSS that emerged during the discussions were derivatives of both historical and contemporary stereotypes that originated from slavery in the United States.

Results

Sample Characteristics

Table 3 describes demographic and sexual behaviors characteristics of the 26 study participants.

Table 3.

Demographic and Sexual Behavioral Characteristic of Focus Group Participants.

Variables FG participants, n/N (%)
Demographic
 Median age (range in years) 20 (18–25)
 U.S.-born
  Yes 24/26 (92)
 Education
  High school/GED 10/26 (40)
  Some college/trade school 14/26 (54)
  College degree 1/26 (4)
 Current student
  Yes 11/26 (42)
 Employment status
  Employed (part-/full-time) 14/26 (54)
  Unemployed 12/26 (46)
 Annual income
  Less than $19,999 19/26 (73)
  $20,000–$39,999 2/26 (8)
  More than $40,000 5/26 (19)
 Relationship status
  Committed 16/26 (62)
  Single 10/26 (39)
Sexual behavioral
 Steady partner
  Sex with steady partner 24/26 (82)
  Steady partner has other sex partner(s) 10/24 (39)
  Inconsistent condom use with steady partner 21/24 (81)
 Non-main partner(s)
  Sex with non-main partner(s) 10/26 (39)
  Non-main partner(s) has other sex partner(s), n = 10 5/10 (50)
  Inconsistent condom use with non-main partner(s), n = 10 5/10 (50)
 HIV test, past year
  Yes 17/26 (65)
 STI (lifetime)
  Yes 10/26 (39)
 Use of drugs/alcohol during sex
  Yes 20/26 (77)
 Prior knowledge
  PEP 17/26 (65)
  PrEP 19/26 (73)
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Note. FG = focus group; STI = sexually transmitted infection; PrEP = pre-exposure prophylaxis; PEP = post-exposure prophylaxis.

Sexual Stereotypes Based in Gender Expectations

Thematic analyses revealed that RBSS may cause women to adopt more traditional gender roles in Western society, making them less likely to feel empowered in sexual decision making. The gender norms reported by the participants reflected wide-ranging characteristics from both historical (jezebel) and contemporary (thot) stereotypes that were reinforced by potential male partners. Stereotypes were most often tied to how Black women were supposed to behave in relationships with their male partners, including relationship dynamics and number of sexual partners. Participants frequently noted that infidelity was normal among men and men were expected to have multiple sex partners and enjoy sex. On the contrary, traditional relationship scripts dictated that women are either categorized as nonsexual or promiscuous like the Jezebel archetype, with their sexual expression being driven by acceptance from male partners.

The participants introduced a new modern of the Jezebel archetype called “thot” when explaining this dynamic between men and women. “I feel like today—Just like sexual wise, if you’re not doing something that all the other girls might be doing you’re the outcast. I feel like there’s a whole ‘thot’ movement now.” Another participant not only provided her explanation of a thot, but how women who do not behave in the same manner are not given the same attention from men:

I don’t know about everybody else but I think a thot is a hoe and she’s down for whatever and now you have girls who are losing their morals and they’re doing whatever just to be down and the girls who are more reserved, they’re not really looked at.

This was supported by other participants when discussing how Black women were viewed by potential male partners.

“You’re supposed to be a female; you’re supposed to be ladylike—a flower. You’re supposed to keep yourself clothed and stuff like that. How are we supposed to do that if these thots out here are doing other things? And that’s when they say what you won’t do for a man, another woman would.

When the group was asked to explain the term thot, another participant not only provided a definition for the term but also linked it to physical attributes such as hair and sexual expectations that the women considered to be immoral.

Basically, to help you. THOT means That Ho Over There. It’s an acronym but basically they want you to be a certain kind of way, they want you to have a certain type of length of hair and what makes it hard is when there are those great African women that don’t give out themselves, they get mad because they expect it so much because all of the other women are always giving it to them.

Participants reported that women were not viewed as attractive or given the same amount of attention as women who lived up to the stereotypes of women who were characterized as being ostentatious or promiscuous. This arrangement of social paradoxes created a theme of internalized misogyny/sexism among the participants where they expressed that women who had multiple sex partners made it difficult for other women to express their sexual agency to potential sex partners. Women were even labeled as being “immoral” for having casual sex and multiple partners: “Some men are just looking for certain types of females that have no morals for themselves like going out with them and doing things on the first night.” In addition, the women expressed that women were expected to minimize characteristics that are usually associated with the Superwoman archetype, such as independence and strength, that have traditionally been associated with masculinity to attract not only potential sex partners but future spouses.

Because the stereotype is so out there about Black women being so strong and independent or supposed to be strong and independent that they try and shy away from that. So they’re like, let me dim down my light a little bit so I don’t scare away my potential husband. Let me be passive or let me be, you know, like my man take control because how am I going to get a man if I don’t act this way, you know? So that might be it too.

The women discussed exaggerated, stereotypical, feminine, social, and sexual traits that made women feel as if they were in competition for partners and conflicted about what was viewed as socially acceptable behavior for women in relationships with men.

How Does Race-Based Sexual Stereotyping Affect Sexual Decisions

Participants reported that RBSS may lead Black women to have relinquished their autonomy in the initiation of sexual activity and resist learning new information about safer sex practices due to stigma associated with female sexuality expression and HIV within society. One participant reported that it was difficult to navigate sexual decision making because there were negative consequences associated with expressing their sexual agency.

Like we are supposed to and it’s not our choice to say yes or no. I feel like we’re sex slaves to people and don’t have an answer anymore. We get into relationships and we’re automatically supposed to give sex to somebody. No. I don’t want to have sex with you. I got into a relationship with you because I like you, not for what’s in between your legs.

Another woman stated that Black women could receive negative reactions for both refraining from sex and sexual permissiveness: “Basically if we’re not opening our legs, they’re not happy and then when we do open our legs, they’re like ‘Oh, you’re a ho.’” Another participant spoke about how women are classified as being “angry” when they express their desire to not have sex or engage in safer sex practices:

It’s bad because we do protect ourselves better and that’s when they come again saying that we crazy, that we have attitude problems, that we’re loud because that’s just our way of protecting ourselves, but you guys see it as being closed off and being angry all the time. That’s what I hate. “Oh you’re another angry Black person.”

Such tainted perceptions of Black women as loud, aggressive, angry, and stubborn promote the Sapphire archetype in present-day culture.

RBSS also incited YBW to feel less empowered within intimate relationships and more likely to jeopardize their sexual wellbeing to affirm themselves in different types of sexual relationships by engaging in condomless sex and relationships with men who have multiple sex partners.

We want a guy to love us that’s why we give it up and that’s why we have what they want and most of them want unprotected sex because they want to feel it and if we don’t do it we’re whack and there will be a next female that will do it.

Participants discussed how having children with someone causes women to stay in unhealthy relationships to avoid the negative stereotype associated with the Matriarch, single mother archetype, and the Welfare Queen archetype to avoid having children from multiple fathers.

In terms of women trying to get pregnant, I see a lot of women, a lot of African-American women who stay in a relationship or continuously have sex with partners because they had a child with them already because they don’t want to be labeled as the Black woman with a whole bunch of baby daddies.

Black women who display behaviors that do not align traditional standards of femininity in which they are expected to be docile, diffident, and selfless have real-life consequences that dictate their lives on an individual, interpersonal, and social level. Black women.

Discussion

This analysis of YBW’s experiences of gendered racism and agency illustrates the cultural context of the sexual socialization of Black women (Campos et al., 2016; Stephens & Phillips, 2005). The women in the study expressed that their attractiveness to male partners depended on cultural scripts that were hyperfeminine and sexual (Stephens & Phillips, 2005) and stereotypes were exemplified in sexual interactions with men. Finally, the women identified stereotypes related to gender/sex-based behavior and racial socialization that have been internalized as normative and appropriated for sexual scripts. The findings confirmed the importance of utilizing the integrated as a means to explain and analyze the influence of RBSS on the sexual socialization of YBW in American culture.

The participants reported that YBW adopted more traditional gender stereotypes, making women feel less empowered in their sexual decision making. Previous research has found that sexual scripts for Black women imposed male dominating ideals such as satisfying men’s physical desires, reproducing children, and being the moral gatekeepers for their communities (Bowleg et al., 2004). Many of these gendered norms manifest as relationship preferences and acceptance of multiple concurrent relationships that may increase HIV infection susceptibility (Amutah, 2012). Such perceptions of masculinity and femininity has been shown to be disruptive to the usage of contraceptives and other risk-avoiding activities (Paxton et al., 2013). Negotiating safer sex when a partner does not have favorable attitude toward using condoms, and when the suggestion of condom use introduces questions of infidelity, becomes increasingly difficult with gender power imbalances in safer sex negotiations (Caldwell & Mathews, 2015; Corbett et al., 2009). This dynamic has been reported in previous research with Black women as it relates to sexual assertiveness in relationships which may be hindered by the sexual double standard of traditional gender norms (Amutah-Onukagha, Opara, et al., 2018; Bowleg et al., 2015) and historical contexts that undergird Black women’s attempt at achieving agency in heterosexual relationships (Awosan & Opara, 2016).

Contrasting characteristics related to femininity were identified in the study that interferes with the women expressing their own sexual agency out of fear of being labeled as promiscuous while also creating the dilemma of wanting to be attractive to potential male partners. The women reported that Black women were more likely to compromise their own agency and minimized their willingness to facilitate condom use discussion to avoid tension and conflict within the relationship (Kennedy & Jenkins, 2011;Yoo et al., 2014). The women in the study posited that stereotypes made them feel less empowered within intimate relationships and more likely to jeopardize their sexual well-being to affirm themselves in other social areas by engaging in unprotected sex and relationships with men who have multiple sex partners. Similar to previous studies, the participants expressed that women fear being branded as promiscuous when attempting to discuss safe sex practices; however, the sexual assertiveness of women can predict greater condom use efficacy (Jenkins & Kennedy, 2013; Woolf-King & Maisto, 2015). Participants reported that RBSS may lead Black women to be resistant to learning new information about safer sex practices due to HIV stigma within the Black community. While most of these studies examining sexual assertiveness have not accounted for the role of not only race but racism, these findings link sexual assertiveness to refusal of unwanted sex among Black women (Amutah-Onukagha, Mahadevan, et al., 2018).

Implications for Practice

Our study has implications for HIV/AIDS interventions targeting YBW highlighting the importance of centering Black women’s collective experience and addressing the oppressive racial and gender ideologies that impact their health. Past and current research, health policy, and practice efforts with Black women tend to have a health disparity focus (Bowleg, 2012; Crepaz et al., 2017) and target women who are low-income, lack educational attainment, and have a history of substance use problems due to their lack of access to services (Newsome et al., 2018). This has allowed for most research related to Black women to ignore the continuum of racism-related experiences that began in slavery, address them as interconnections to health disparities, and address how racism foster adverse sexual and reproductive health outcomes for Black women (Flowers, 2018). By not focusing on the sociocultural and structural factors that contribute to Black women’s vulnerability to HIV/STI, we have a limited view of their sexual scripts. Not only are culturally appropriate, tailored interventions implemented by cultural congruent researchers recommended to advance research with Black women, it is essential that decision makers, conceptualize diversity beyond “non-White” (Flowers, 2018; Prather et al., 2016). Black women are diverse unto themselves in terms of ethnicity, religion, socioeconomics, geographic locations, and cultural belief practices, but we experience similar discrimination because of the racism embedded in American culture (Prather et al., 2018). Both protective factors and risk factors should be considered when developing interventions and programs targeting Black women’s sexual and reproductive health (Rao et al., 2018). Therefore, it is essential that researchers examine their own biases about Black women before they design research studies and interpret data about sexual and reproductive health (Prather et al., 2018).

Limitations

It is important to point out that this study has limitations. This is small sample of a selected group of cisgender YBW with male sex partners and is not representative of all Black women. We are mindful that our capacity to generalize to what degree these dynamics are reflective of other Black women has been constrained by the small sample size. The format of the focus group discussion was developed as part of a larger study to develop an eHealth intervention to increase awareness and knowledge about PrEP and not explicitly design to explore RBSS. Our RBSS and sexual script analyses were mainly exploratory, our research concentrated on data that came from narratives rather than on responses to structured interview questions. We cannot assume that all Black women are monolithic, it is important to recognize that the experiences of Black women may vary depending on ethnicity, age, socioeconomic status, sexuality, and environment. It is important to note that despite these differences among Black women living in the United States, experiences of racism are common among Black women in society (Prather et al., 2018). Furthermore, intersectionality through the integration of Black feminist thought was included as part of the theoretical framework for the study analysis to account for the influence of sociohistorical marginalization powers (Abrams et al., 2020; Collins & Bilge, 2020). The participants engaged in cultural self-reflection in relation to others by focusing on themselves and what is happening in their own environment in relation to the people in their culture. Through the focus group discussions process, they were able to shift from focusing on self to thinking more broadly on interpersonal and system levels, taking historic, political, social, economic, racial, and cultural realties into consideration (Milner, 2007).

Conclusion

YBW experience with gendered racism has allowed for the creation of enduring patterns of disempowering social conditions related to their sexuality and engagement of sexual health care. Researchers need a broader understanding and awareness of the historical context as it relates to sexuality in order to tackle the barriers to HIV prevention, which include recognizing the gender racism experienced by Black women and the societal challenges they continue to face when it comes to sexual decision making. Future research should focus on understanding the historical, social, and cultural factors that influence Black women’s capacity to maintain and refine their sexual health, including the aforementioned stereotypes that shape their sexual expectations and their encounters with the health care system. Studying encounters that Black women’s experience gendered racism within the everyday context of their lives has the potential to give insight toward what steps needed to be taken to dispel RBSS and intervene the problem that enhance stigma associated with sexual health outcomes. Improving Black women’s sexual health with educational tactics and policies that address implicit and explicit bias can result in the development of resolutions on the community and societal levels.

Acknowledgments

This article and the research behind it would not have been possible without the exceptional support of staff at Project HEAT and Acria, Inc., especially Tiffany Patterson and Dr. Sara C. Flowers.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The first author was supported by a T32 Behavioral Science Training at New York University Rory Meyers College of Nursing post-doctoral fellowship (T32DA007233-33). This research was supported by the Center for Drug Use and HIV Research (CDUHR-P30 DA011041) and the National Institute of Mental Health of the National Institutes of Health under Award Number R25MH087217. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Footnotes

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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