Background: HIV and STIs disproportionately affect African American women despite evidence that disparities are not caused by increased behavioral risk-taking among the population. Rater, recent research implicates population-level characteristics for the disparity. HIV and STI risk reduction communication efforts targeting African American women often focus on increasing condom use and HIV testing behaviors, but rarely center on communication and do not address relationship factors that might result from population-level conditions. Objective: The primary objective of this research is to explore the unique shared lived experience of young adult African American women navigating sexual relationships and use findings to craft culturally appropriate messages. Methods: This goal was met by first exploring sexual relationships among the population using qualitative interviews. Eleven women participated in in-depth narrative interviews lasting from 46 to 129 minutes. Using narrative analysis, eight themes were interpreted from the data. Findings were used to inform the development of a model predicting partner concurrency acceptance, a scale measuring attitudes toward partner concurrency, and targeted communication materials. Finally, materials were pilot tested with an advisory board. Results: Women in the study accepted partner concurrency for a multitude of reasons that were largely influenced by power dynamics and social influences. Participants described relationships that fit into three main categories. Meaning that informed womens reasons for accepting concurrency, their responses to concurrency, the extent to which they were comfortable communicating with a partner about concurrency, and their condom use with a partner engaging in concurrency was ascribed to each relationship type. Based on these findings, communication materials were developed that targeted women based on their relationship type. Three narratives reflecting the findings were featured in three targeted factsheets. Further, two scales were developed that could be used to test the effectiveness of these fact sheets in changing knowledge and attitudes related to partner concurrency. Conclusions: The findings from this research reflect the unique shared experience of young adult African American women navigating dynamic sexual relationships. Based on the findings, public health professionals should consider the complex nature of relationships in African American sexual networks when crafting HIV and STI prevention messages.
