Racial pride, self-efficacy, and condom use: Test of a conceptual model for the MILE Intervention for post-incarcerated African American men who have sex with men and women

African American men who have sex with men and women (MSMW) are affected by elevated rates of HIV infections compared to other MSMW. Those who have been incarcerated are at further risk of infection. Men in Life Environments (MILE) is a culturally tailored skills-based HIV prevention intervention based on an intersection of the Theory of Planned Behavior, the Critical Thinking and Cultural Affirmation (CTCA) Model, and Empowerment Theory. In the present study, we sought to test whether associations between a subset of our study constructs at baseline align with our theoretical framework for the MILE intervention – namely, whether higher levels of self-concept, specifically racial pride, is met with higher self-efficacy, intentions, and sexual health practices in African American MSMW. We recruited 212 participants who had been incarcerated in the prior 12 months from Los Angeles based agencies, participant referrals, and men leaving the County Sheriff’s Department, Men’s Central Jail. We utilized structural equation modeling using baseline data to assess relationships between racial pride, self-efficacy, intentions, and condom use. We tested two separate models, testing outcomes with female sexual partners separately from those with male sexual partners. Self-efficacy mediated the association between racial pride and condom use intentions with both female and male partners. Although intentions were associated with condom use behaviors with male partners, this was not seen with female partners. Findings suggest that promoting racial pride is important in HIV prevention programs aimed at building skills and encouraging behaviors that protect sexual health in post-incarcerated African American MSMW.