Investigaciones realizadas

This study, grounded in relevant theory and empirical evidence on religious socialization, religiosity, and racial identity, makes several contributions to understanding and addressing race- specific inequities in HIV/STD prevention among black adolescents. First, this dissertation presented a re-conceptualization of two important social determinants of sexual health among black adolescents: religiosity and racial identity. Second, innovative measures and intersectional approaches were used to operationalize and examine the complexity of black adolescents’ religious socialization, religiosity, and racial identity as social determinants of their sexual

initiation. Lastly, these findings underscore potential leverage points for HIV/STD prevention efforts for black adolescents. While the strengths of this research are substantial, these findings and implications should be interpreted in light of several study limitations.

The cross-sectional nature of the NSAL is a limitation, as temporality cannot be established for the identified relationships. This limitation is significant; however the NSAL provides measures that support a more robust and in-depth examination of black adolescent religiosity and racial identity that other available quantitative datasets do not offer. The study sample is comprised of both African American and Caribbean black adolescents. Not only does the absence of data from white adolescents pose a limitation when examining health disparities, one that is addressed through the use of an intersectional approach to intra-group analyses, but it also raises questions of generalizability. Moreover, due to the sampling frame used by the NSAL, study findings may not be generalizable to the larger diverse Caribbean black sub- population. Not capturing this diversity poses a challenge in that Caribbean black adolescents experience varying degrees of acculturation that may operate to maintain or diminish native culture and norms related to sexual health behaviors.

The measure used for black adolescent religiosity is robust and accounts for the complexity and structure of the construct; however, other measures in this study are not as comprehensive. Theoretical models of religious socialization describe a process that accounts for message content and reciprocal exchanges between adolescents and a variety of socialization agents, including parents, peers, religious leaders, and mentors. For the sake of analysis, I simplified religious socialization to be a composite measure of the frequency of adolescent exposure to religious messages from parents and family members. Although this measure demonstrated strong internal reliability, conceptually, it did not take into account the content or

quality of religious messages. Knowing the content and quality of religious messages would reveal if messages endorsed certain dimensions of religiosity more than others or encouraged abstinence only, which could provide insight into the underlying processes of religious

socialization. An important next step would be to expand this measure of religious socialization to include message content and some metric of message quality.

There are other factors associated with adolescent sexual initiation not measured in the NSAL that may influence the identified relationships. For example, I did not account for parental monitoring of adolescent behavior. The observed relationships could in part be due to religiosity being a proxy for parental monitoring and control, or that the protectiveness of religiosity with regard to sexual initiation may be confounded by factors related to the parent-adolescent relationship, particularly parental monitoring and control. Items assessing parental monitoring were not included in the NSAL and are therefore not included in the current study. Also missing are measures of adolescent sexual orientation and relationship status, both of which have been shown to be associated with adolescent sexual initiation and to have implications for future sexual health behaviors. The inclusion of these factors to the discussion of black adolescent religiosity and sexual initiation is warranted.

Social control theory suggests that adolescent engagement in risky behavior is not isolated to one particular act. That is, adolescents begin to engage in a number of harmful behaviors, such as alcohol and tobacco use, around the same time. This dissertation exclusively measured sexual initiation, which fails to consider the clustering of adolescent risk behaviors. For religiously-minded adolescents, sexual initiation may be on the end of the spectrum for risky behavior, after they have experimented with alcohol or tobacco.

Lastly, I used intersectionality to support a theoretical argument (i.e., intra-group variability is necessary to the study of racial sexual health disparities, and that religiosity and racial identity are mutually constitutive) and a methodological approach (i.e., LPA) to testing the interaction of categories of identity and identity formation. Intersectionality provides the most guidance for interpreting religiosity-racial identity profiles, and how these profiles can be used to shape public health practice (see Chapter 7.3). Intersectionality is often used to describe

mutually oppressive identities. While in some instances religion can be viewed as an oppressive identity, particularly for women, this dissertation did not conceptualize it as such. Rather, intersectionality is used to demonstrate how two identities can serve a protective function for black adolescents. The literature on operationalizing intersectionality in this manner is limited. However, Cole (2009) argues that a necessary corollary to the use of intersectionality to describe experiences of members of marginalized groups is the consideration of members within these groups who also have privileged identities, such as middle-class blacks. While black racial identity is an oppressive social identity, one could argue that religiosity, as operationalized in this dissertation, may be considered a more protective or privileged component of identity. This argument is not tested in this dissertation and as such, perhaps a relational identity theory, such as social identity theory, could provide more guidance on conceptualizing these identity

functions. Nevertheless, I contend that intersectionality is most appropriate for this line of inquiry given that I measured internal and external dimensions of religiosity that account for more than religious identity alone.