Condom Knowledge and Negotiation in Women Living with and without Human Immunodeficiency Virus

Abstract

Objective: To assess condom and sexual knowledge, condom use and negotiation tactics of HIV positive and negative women, and identify any unmet need for education. Methods:We compiled the survey instrument from previously psychometrically validated questions, including condom knowledge, use, and negotiation skills. We recruited a convenience sample from the Obstetrics and Gynecology and Infectious Disease Clinic waiting rooms. In our analysis, we used descriptive statistics: T-tests, Wilcoxon rank sum, Chi-square and Fisher exact tests and multivariate logistic regression. Results:We collected 438 questionnaires; 114 respondents were HIV positive. Median age was 39.6 and the majority were African American (87.9%). HIV positive women had lower levels of education and income, but higher number of lifetime sexual partners and pregnancies. HIV positive women were more likely to report condom use (80% vs. 45.4% p=0.0001) and consistent condom use; 71% reporting "most of the time" or "always" vs. 43.3% (p=0.0001). Only 53.2% of HIV negative women and 75.4% of HIV positive women reported negotiating condom use when their partner declined (p<0.0001). HIV positive women were more likely to report using condom negotiation strategies such as autocracy, bargaining, bullying, disengagement, manipulation, and supplication.Conclusions: HIV positive women reported increased condom knowledge, use and negotiation skills compared to their HIV negative counterparts. Gaps in knowledge, condom use, and negotiation skills highlight need for further education and empowerment of women with and without HIV to prevent spread of HIV in this high-prevalence, high-risk population.Keywords: Condom Knowledge; Condom Negotiation; HIV Capsule: HIV positive women reported increased condom knowledge, use, and negotiation skills compared to their HIV negative counterparts, highlighting the need for further education and empowerment of women with and without HIV to prevent spread of HIV. Journal of Women's Health and Gynecology