Correlates of HIV Infection Among African American Women from 20 Cities in the United States

Ivy, Wade; Miles, Isa; Le, Binh; Paz–Bailey, Gabriela

doi:10.1007/s10461-013-0614-x

Cited by 25 publications

(17 citation statements)

References 50 publications

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“…In addition to issues related to mental health and drug treatment, stimulant use has been consistently linked with a variety of serious physical health consequences, including HIV and hepatitis C infections (Fischer et al, 2008; Ivy et al, 2013; Novak et al, 2013; Nyamathi et al, 2002), poor clinical outcomes among HIV and HCV-infected women (Carrico et al, 2011; Operskalski et al, 2008; Riley et al, 2011), arrhythmias and sudden death caused by stimulant-induced arrhythmia occurring in the absence of traditional risk factors like infarction (Hsue et al, 2007; Lange and Hillis, 2001). We recently reported a 3% annual mortality rate among 300 homeless women living in San Francisco over a four-year observation period (Riley et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Risk factors for stimulant use among homeless and unstably housed adult women

Riley

Shumway

Knight

et al. 2015

Drug and Alcohol Dependence

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Background One of the most common causes of death among homeless and unstably housed women is acute intoxication where cocaine is present. While correlates of stimulant use have been determined in prior research, few studies have assessed risk factors of use specifically in this high-risk population. Methods We sampled biological women with a history of housing instability from community-based venues to participate in a cohort study. Baseline and 6-month follow-up data were used to determine the relative risk of stimulant use (crack cocaine, powder cocaine or methamphetamine) among individuals who did not use at baseline. Results Among 260 study participants, the median age was 47 years, 70% were women of color; 47% reported having unmet subsistence needs and 53% reported abstinence from stimulants at baseline. In analyses adjusting for baseline sociodemographics and drug treatment, the risk of using stimulants within 6 months was significantly higher among women who reported recent sexual violence (Adjusted Relative Risk [ARR] = 4.31; 95% CI:1.97–9.45), sleeping in a shelter or public place (ARR = 2.75; 95% CI:1.15–6.57), and using unprescribed opioid analgesics (ARR = 2.54; 95% CI:1.01–6.38). Conclusion We found that almost half of homeless and unstably housed women used stimulants at baseline and 14% of those who did not use began within 6 months. Addressing homelessness and sexual violence is critical to reduce stimulant use among impoverished women.

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Section: Introductionmentioning

confidence: 99%

Risk factors for stimulant use among homeless and unstably housed adult women

Riley

Shumway

Knight

et al. 2015

Drug and Alcohol Dependence

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“…[4][5][6] In addition, social and economic disadvantage, homelessness, and incarceration have been shown to be associated with sexual risk behavior and HIV infection. [7][8][9][10][11][12][13][14][15][16] Partner-related or sexual network factors have also been shown to be important in HIV risk among women, including sexual partner drug use, partner incarceration, concurrent sexual partnerships and assortative mixing (e.g., sex with other people from the same race and/or ethnicity). 7,9,[17][18][19][20] Limited data are available on the longitudinal occurrence of syndemic factors among women and how these factors relate to sexual risk over time.…”

Section: Introductionmentioning

confidence: 99%

HIV Sexual Risk and Syndemics among Women in Three Urban Areas in the United States: Analysis from HVTN 906

et al. 2015

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on behalf of the HVTN 906 study team ABSTRACT Limited data are available on the longitudinal occurrence of syndemic factors among women at risk for HIV infection in the USA and how these factors relate to sexual risk over time. HVTN 906 was a longitudinal study enrolling 799 HIV-uninfected women in three cities. Assessments were done at baseline, 6, 12, and 18 months to assess syndemic factors (low education, low income, unemployment, lack of health insurance, housing instability, substance use, heavy alcohol use, partner violence, incarceration) and sexual risk outcomes. For each sexual risk outcome, a GEE model was fit with syndemic factors or syndemic score (defined as sum of binary syndemics, ranging from 0 to 9), visit, study site, age and race/ethnicity as predictors to examine the multivariable association between syndemic factors and outcomes over time. Odds of unprotected sex while drunk or high were significantly higher when women reported lack of health insurance, substance and heavy alcohol use and partner violence. Housing instability, substance and heavy alcohol use, partner violence and recent incarceration were associated with higher odds of having multiple sexual partners. Odds of sex exchange were significantly higher in the presence of unemployment, housing instability, low education, lack of health insurance, substance and heavy alcohol use, partner violence and incarceration. Housing instability, substance and heavy alcohol use, and partner violence were significantly associated with higher odds of unprotected anal sex. Odds of having a recent STI were significantly higher when women reported housing instability and partner violence. There were significantly higher odds of the reporting of any risk outcomes during follow-up with higher syndemic score. This study highlights a group of women experiencing multiple poor social and health outcomes who need to be the focus of comprehensive interventions.

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“…Twenty percent reported that they themselves had more than one sexual partner, but middle-age African American women are no more likely to have multiple sexual partners than women of other races (Moreno, El-Bassel, & Morrill, 2007; Sormanti, & Shibusawa, 2007). A woman’s HIV risk is not only due to individual risk factors, it is equally dependent on her sexual partner’s risk behavior (Ivy, Miles, Le, & Paz-Bailey, 2014). Many of the women in this study were considered to be at increased HIV risk because of their main partners’ risky sexual behaviors.…”

Section: Discussionmentioning

confidence: 99%

“…Thirty percent reported that incarceration created an imbalance in the male-to-female ratio in the African American community, resulting in a shortage of men. Gender-ratio imbalance occurs when the number of eligible African American women exceeds the number of eligible African American men, due not only to the higher incarceration rates but also to various socioeconomic and education differences and the higher mortality rates of African American men (Adimora, Schoenbach, & Floris-Moore, 2009; Ivy et al, 2014). Low socio-economic status, living in impoverished communities, and gender/sex-ratio imbalance increases HIV vulnerability for African American women (Harris et al, 2010; Ivy et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…The male shortage affects older women because their dating potential is diminished, which may reduce the power and ability to negotiate personal needs in the sexual relationship (Harris et al, 2010). Further, male shortages create an imbalance in the African American community and can lead to Black women sharing male partners or having concurrent sexual partnerships that contribute to HIV susceptibility (Harris et al, 2010; Ivy et al, 2014). Therefore, HIV prevention strategies should address male shortages in the African American community by targeting public health and social policies geared at eliminating racial disparities including the disproportionate incarceration of Black men (Ivy et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Sexual Protective Strategies and Condom Use in Middle-aged African American Women: A Qualitative Study

Smith¹

2015

Journal of the Association of Nurses in AIDS Care

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The heterosexual transmission of HIV has affected middle-age African American women at alarming rates; yet there is a paucity of research and interventions focused on this population. This study used a qualitative approach to understand middle-age urban African American women’s experiences with HIV-related sexual risk behaviors and to identify the sexual protective strategies they employed to reduce their risk for HIV infection. Ten African American women, ages 45 to 56, were recruited from low-income neighborhoods in New York City. Data were collected using in-depth interviews and analyzed using content analysis. Investigator triangulation and member checking were used to ensure rigor. Five salient themes emerged that highlighted the individual, gender/relationship power factors, and the sociocultural elements that influenced sexual protection or risk-taking behavior. Findings provide new insight into the complexities of HIV sexual risk behavior and can guide future HIV prevention interventions for middle-age, African American, urban women.

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Correlates of HIV Infection Among African American Women from 20 Cities in the United States

Cited by 25 publications

References 50 publications

Risk factors for stimulant use among homeless and unstably housed adult women

Risk factors for stimulant use among homeless and unstably housed adult women

HIV Sexual Risk and Syndemics among Women in Three Urban Areas in the United States: Analysis from HVTN 906

Sexual Protective Strategies and Condom Use in Middle-aged African American Women: A Qualitative Study

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