Dimensions of Sexual Health Conversations among U.S. Black Heterosexual Couples

Natalie M. Leblanc, Noelle M. St. Vil, Keosha T. Bond, Jason W. Mitchell, Adrian C. Juarez, Faith Lambert, Sadandaula R. Muheriwa, James McMahon

Research output: Contribution to journalArticlepeer-review


Sexual health communication is an important feature of healthy intimate relationships; however, some couples may avoid discussing difficult matters (e.g., HIV/STI testing, sexual satisfaction) to minimize interpersonal conflict. From October 2018 to May 2019 in New York State, we conducted a multi-method descriptive pilot study to characterize Black heterosexual couples’ (N = 28) sexual health conversations. Partners individually completed an online sexual health/relationship survey before engaging in-person for a joint dyadic qualitative in-depth interview. Quantitative descriptive statistics demonstrated that most absolute score differences among couple’s preferences for sexual health outcomes, communal coping and sexual relationship power were mainly small, but greatest regarding extra-dyadic sexual behaviors. A qualitative descriptive approach discerned, motivation and norms for sexual health conversations, and communication patterns. Thematic and content analysis revealed two central themes: initiating and sustaining sexual health conversations, and leveraging features of the couples to promote sexual health. Integrated findings indicate that couples possess varied communication patterns that operate with motivations for sexual health conversations toward subsequent sexual health promotion. Equitable and skewed communication patterns emerged as relationship assets that can be leveraged to optimize sexual health. There is also opportunity for future work to address communication regarding extra-dyadic behavior and preferences. Asset-based considerations are discussed.

Original languageEnglish (US)
Article number588
JournalInternational Journal of Environmental Research and Public Health
Issue number1
StatePublished - Jan 2023
Externally publishedYes


  • black couples
  • dyadic analysis
  • health communication
  • heterosexual
  • sexual health

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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