The Sexual Concerns of African American, Asian American, and White Women Seeking Routine Gynecological Care

MAJ Margaret R. Nusbaum; Loretta Braxton; Gregory Strayhorn

doi:10.3122/jabfm.18.3.173

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Table 1.

Comparison of Demographic Characteristics among White, African American, and Asian American Women

Characteristics	White Women% (N)	African American Women% (N)	Asian American Women% (N)
Employment Status
Outside of home	39 (276)	58 (38)	41 (45)
Homemaker	33 (234)	30 (20)	13 (14)
Homemaker and childcare	12 (86)	8 (5)	43 (48)
Other	15 (105)	5 (3)	4 (4)
Missing data	0.5 (3)
Education
≤Some high school	7 (47)	11 (7)	21 (23)
Completed high school	30 (208)	36 (24)	41 (37)
Some college	40 (281)	30 (20)	29 (32)
≥College degree	23 (164)	23 (15)	14 (15)
Missing data	1 (4)
Relationship
Married	86 (603)	86 (56)	83 (92)
Widowed	6 (42)	3 (2)	15 (17)
Living together	3 (18)		1 (1)
Single/never married	2 (17)	2 (1)	1 (1)
Single/divorced	2 (14)	2 (1)
Other	1 (10)	8 (5)
Missing data		2 (1)
Income
≤$25,000	34 (239)	35 (23)	41 (45)
>$25,000 to $40,000	33 (233)	41 (27)	36 (40)
>$40,000 to $55,000	17 (116)	14 (9)	12 (13)
>$55,000 to $70,000	8 (59)	3 (2)	2 (2)
≥$70,000	5 (34)	2 (1)	2 (2)
Missing	3 (23)	6 (4)	8 (9)
Religious Conviction
Very strong	18 (124)	8 (5)	21 (23)
Strong	19 (130)	16 (10)	12 (13)
Somewhat strong	25 (175)	23 (14)	20 (22)
Not strong	21 (148)	23 (14)	22 (24)
None/absent	18 (122)	31 (19)	24 (27)
Missing data	1 (5)	6 (4)	2 (2)
Mean age (years)	46	39	48

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Table 2.

Prevalence and Comparison of Sexual Concerns among African American, Asian American, and White Women

Sexual Concerns	White Women N = 704 %	African American Women N = 66 % (POR)	Asian Women N = 111 % (POR)
Lack of interest in sex	89	84 (0.52)^*	72 (0.56)^†
Difficulty having orgasm	87	79 (0.61)^*	72 (0.42)^‡
Vaginal lubrication	76	63 (0.45)^†	74 (0.82)
Lack sex appeal	72	62 (0.69)	47 (0.39)^‡
Dyspareunia	72	77 (0.86)	69 (0.91)
Unsatisfied sexual needs	69	73 (1.13)	54 (0.45)^‡
Need sex information	65	70 9 (1.25)	55 (0.62)^*
Desires different than partners	62	53 (0.77)	51 (0.75)
Contraception, family planning, fertility	62	73 (1.51)	48 (0.64)^*
Inability to have orgasm	61	60 (0.69)	61 (0.52)^†
HIV/AIDS	52	76 (3.54)^§	54 (1.57)^†
Safe sex/sexually transmitted diseases	52	68 (3.79)^§	51 (1.67)^†
Partner sexual difficulties	49	41 (0.89)	41 (0.58)^†
Difficulty inserting penis	48	44 (1.11)	56 (1.46)^*
Thinking too much about sex	39	44 (1.88)^†	37 (0.94)
Adult sexual coercion	36	46 (1.92)^†	21 (0.72)
Adult emotional/physical abuse	36	32 (1.06)	22 (0.43)^†
Childhood emotional/physical abuse	34	36 (1.02)	19 (0.47)^†
Want to have/have had an affair	34	52 (2.41)^†	21 (0.80)
Sexual aversion	33	32 (1.49)	34 (1.78)^*
Hard to control sexual urges	30	32 (1.39)	25 (1.09)
Sexual orientation	25	28 (1.54)	29 (1.71)
Sexual interest in women	20	23 (1.53)	20 (0.87)
Childhood sexual coercion	17	20 (1.27)	12 (0.61)
Wish to be opposite sex	16	14 (1.90)	15 (1.09)
Sexually abusive towards others	15	4 (5.44)	8 (9.76)^*

Kruskal Wallis test χ² = 0.412, df = 2, P = .814 to compare relative rank of sexual concerns among the 3 racial/ethnic groups. POR, Prevalence odds ratio after controlling for demographic variables age, marital status, religion, income, and education:
* 0.1 ≤P≤.05,
† P ≤ .05,
‡ P ≤ .01,
§ P ≤.001, of African American and Asian American compared with White women.

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Table 3.

Predictors of High Number of Sexual Concerns among White, African American, and Asian American Women with Sexual Coercion in Logistic Equation*

Characteristic	Overall OR (95% CI)	White OR (95% CI)	African American OR (95% CI)	Asian American OR (95% CI)
Sexual Coercion
No	1	1	1	1
Yes	5.3 (3, 8, 7.4)	5.7 (4.0, 8.2)	8.9 (1.2, 66.4)	5.9 (1.5, 23.0)
Age
≤45 years	1		1
>45 years	0.7 (0.5, 0.99)		0.01 (0.0, 0.5)
Income
≤$25,000	1		1
$25,000 to ≤40,000	0.6 (0.4, 0.96)		0.05 (0.004, 0.5)
>$40,000	0.7 (0.4, 1.1)
Education
≤High school	1	1		1
Some college	1.9 (1.3, 2.8)	1.7 (1.1, 2.7)		6.6 (1.6, 27.3)
≥College	2.1 (1.3, 3.3)	1.7 (1.0, 2, 8)		25.6 (3.2, 201, 865)

* The referent groups for demographic characteristics were: age ≤ 45; income ≤ $25,000; education ≤ high school, religion = none/absent; relationship = not married; and, for the analysis of the overall cohort, race = white. “No history” of sexual coercion was referent group for this concern. Only statistically significant predictors are included in the table.

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Table 4.

Predictors of High Number of Sexual Concerns among White, African American, and Asian American Women with Physical/Emotion Abuse in Logistic Analysis*

Characteristic	Overall OR (95% CI)	Caucasian OR (95% CI)	African American OR (95% CI)	Asian American OR (95% CI)
Physical/Emotional Abuse
No	1	1
Yes	2.4 (1.7, 3.2)	2.5 (1.8, 3.5)
Age
≤45 years	1		1
>45 years	0.7 (0.5, 0.9)		0.06 (0.003, 1.0)
Income
≤$25,000	1		1
$25,000 to ≤40,000	0.6 (0.4, 0.8)		0.06 (0.007, 0.5)
>$40,000	0.6 (0.4, 0.9)
Education
≤High school	1	1		1
Some college	1.7 (1.2, 2.5)	1.5 (1.05, 2.4)		6.7 (1.6, 28.2)
≥College	1.9 (1.9, 2.9)			20.3 (2.5, 166.1)

* The referent groups for demographic characteristics were: age ≤ 45; income ≤ $25,000; education ≤ high school, religion = none/absent; relationship = not married; and, for the analysis of the overall cohort, race = white. “No history” of physical/emotional abuse was the referent group for this concern. Only statistically significant predictors are included in the table.