HIV/STI risk-reduction policies and programs in the U.S. need to explicitly address overall economic disempowerment among women, as well as racial disparities in poverty. These economic disparities likely contribute both to increasing rates of HIV among women in the U.S. and to the extraordinary racial disparities in HIV/STI risk among American women.

This study examined ethnic differences in self-report and interviewer-rated depressive symptoms and estimated the contributions of sociodemographic and psychosocial factors in predicting severity of depression. One hundred twenty-five clinically depressed African American (n = 46), Caucasian (n = 36), and Latina (n = 43) women were recruited. After controlling for differences in socioeconomic status, African American women reported more symptoms of distress and Latinas were rated as significantly more depressed than the other groups. However, these ethnic differences were not moderated by either education or employment. Finally, hierarchical regression analysis indicated that severity of depression was predicted by low education, being single, being Latina, high perceived stress, and feelings of hopelessness. Additional research is needed to validate these results and to investigate their clinical significance.

Objective To examine the association between sociodemographic factors, sexual behaviors, and social factors on potential uptake of PrEP among African-American and White adult women in the United States. Methods Participants were recruited through a nationally representative random-digit dial telephone household survey. Participants comprised a nationally representative random sample of unmarried African-American (N=1068) and White women (N=441) aged 20–44. Interviews were conducted using computer-assisted telephone interviewing technology. Bivariate and multivariate analyses examined the relationship between sociodemographics, sexual behaviors, and social influences on women’s potential uptake of PrEP. Results In multivariate analyses, women with lower educational status, greater lifetime sexual partners, provider recommendations supportive of PrEP, and peer norms supportive of PrEP use were more likely to report potential PrEP uptake. Racial analyses revealed that compared to White women, African-American women were significantly more likely to report potential use of PrEP (aOR=1.76; p ≤ 0.001), more likely to report use PrEP if recommended by a healthcare provider (aOR=1.65; p≤0.001), less likely to report that they would be embarrassed to ask a healthcare provider for PrEP (aOR=0.59; p ≤ 0.05) and more likely to report use of PrEP if their female friends also used PrEP (aOR=2.2; p ≤ 0.001). The potential cost for PrEP was identified as a barrier to adoption by both African-American and White women. Conclusions Findings suggest that women at increased risk for HIV, including those with less education and greater number of sexual partners, may be more likely to use PrEP, although cost may serve as a barrier.

We examine potential use of pre-exposure prophylaxis (PrEP) among young adult women, based on nationally representative random-digit dial telephone household survey of 1,453 US African-American and white women. The hypotheses were generated based on Health Belief Model. Our analyses showed that, as compared to women of 30-45 years old, young women of 20-29 years old experienced stronger social influences on PrEP uptake. However, as compared to older women, young women did not report higher potential PrEP uptake or adherence, despite their greater risk of HIV. For PrEP to be an effective method of prevention for young adult women, interventions are needed to increase HIV risk awareness.

Growing evidence suggests that drug and alcohol use are fueling the heterosexual transmission of HIV among African Americans. This study aims to examine the relative contribution of drug and alcohol use of male and female partners to risks of heterosexual transmission of HIV among 535 African American HIV serodiscordant couples (N = 1,070 participants) who participated in an HIV prevention trial. Associations found between use of drugs and alcohol by one or both partners and sexual risk indicators varied by type of substance and whether male or female partner or both partners reported use. The findings suggest multiple ways in which substance use of male and female partners may be contributing to the heterosexual transmission of HIV and other STDs among African Americans and underscore the need for HIV prevention strategies to address dyadic patterns of substance use that lead to sexual risks.