“I’m Trusting You with My Body”: A Qualitative Examination of the Role of Trust in Safer Sexual Decision-Making Among Black Women

Black women are disproportionately impacted by HIV, such that they are diagnosed at eight times the rate of White women and three times that of Latinas. Given that HIV transmission among Black women is primarily attributed to heterosexual sex, it is imperative to better understand factors that influence Black women’s sexual health decision-making. Previous studies have highlighted the influence of trust on sexual decision-making; however, scant literature focuses on trust in the relationships of Black women, for whom it may differentially impact their sexual health. Nine focus groups were conducted to examine how trust affects sexual health decision-making among Black women who have sex with men (N = 56). Qualitative analyses revealed three themes that highlight how trust can influence sexual behavior: (1) Trust Buffers Risk of Physical and Emotional Harm; (2) Broken Trust Encourages Safer Sex Behavior; (3) Trust Dynamics Influence Sexual Communication Anxiety. This analysis expands on extant literature by identifying how differing forms of trust can be understood and leveraged in the context of HIV/STI prevention and sexual health for women engaging in heterosexual sex. Implications of the study indicate that concepts of trust should be addressed in interventions seeking to improve the sexual health of Black women.