Examining the Interactive Effect of Conformity to the Thinness Ideal and Depression on Risky Sexual Behavior

Abstract

Compared to White women, Black women are at increased risk for HIV and sexually transmitted infections (CDC, 2018). Previous research on predominantly White women has shown that negative body image reflects conformity to the thinness ideal (James et al., 2001) and predicts high-risk sexual behaviors (Larson et al., 2011; Kvalem et al., 2011). This may have similar relevance for Black women in conferring risk—and this effect may be amplified by depressive symptoms (Thames et al., 2018). We focus on young adulthood given the greater saliency of thinness norms and increased risky sexual behavior during this period (Voelker et al., 2015). It was hypothesized that the relationship between conformity to the thinness ideal and risky sexual behavior is moderated by depressive symptoms such that for women who are relatively higher on depressive symptoms, there will be an increased effect. A community sample of 117 self-identified African American/Black women (M age=21, SD=2.25) were recruited from the Washington, D.C. area. Participants completed self-report measures of thinness conformity (modified version of the Conformity to Feminine Norms Inventory; Mahalik et al., 2005), depressive symptoms (Depression Subscale of the Brief Symptom Inventory; Derogatis, 2001), and sexual risk behavior (Youth Risk Behavior Surveillance System; CDC, 2013). Depressive symptoms moderated the effect of thinness ideal on risky sexual behavior (b =-.03, p =.039), but only for women who were relatively high on depressive symptoms. Moreover, this effect was in the negative direction, contrary to our hypothesis. For women at the mean level of depressive symptoms as well as those below the mean level, there was no effect of thinness ideal on risky sexual behavior. Overall, the model predicted 5% of the variance in risky sexual behavior, F(3,79)=3.19, p =.028. The current findings indicate that women who are nonconforming to feminine norms (e.g., thinness ideal) may externalize depressive symptoms in ways associated with traditional masculinity (e.g., risky sexual behavior). Future research should examine if the thinness ideal adequately applies to African American women.