Human Immunodeficiency Virus (HIV)-Related Risk-Taking Behaviors in Women Attending Inner-City Prenatal Clinics in the Mid-West

Abstract

OBJECTIVE:Federal guidelines recommend the provision of human immunodeficiency virus education to all attendees of prenatal clinics. The current study was conducted to assess risk-taking behaviors among urban women voluntarily pursuing prenatal care. DESIGN AND SETTING:African American women attending urban prenatal clinics in Cleveland, Ohio were subjected to an extensive interview before receiving an experimental AIDS education curriculum. The interview sought detailed information regarding demographics, lifetime and recent sexual activity, condom use, and lifetime and recent illicit drug use. RESULTS:A total of 1017 women were interviewed; of these women, ϳ73% were single. The majority had a monthly income of less than $500. A total of 66% had only one partner in the past year, and almost 90% had Յ1 partner in the past 6 months. A total of 98% identified a main partner. Nearly all subjects were at least fairly certain that this partner did not use intravenous drugs, and 71% were at least fairly certain that he was monogamous. Only 19% used condoms most or all the time. Intravenous drug use among study subjects was very infrequent. CONCLUSION:These data indicate that inner-city Cleveland women seeking prenatal care are largely monogamous around the time of their gestation, and that a history of intravenous drug use is infrequent. They suggest that prenatal counseling in urban clinics will need to address women who largely are engaged in single-partner relationships at the time of the intervention.The mandate to provide voluntary prenatal testing for human immunodeficiency virus (HIV) was strengthened by the discovery that intragestational administration of zidovudine can prevent vertical transmission of virus. 1 However, anonymous serosurveys have indicated that most women presenting in labor are uninfected, even in areas in which the incidence of HIV infection is high. 2 Therefore, guidelines established by the American Academy of Pediatrics, 3 the American College of Obstetrics and Gynecology, 4 and the federal government 5 continue to emphasize the pressing need to provide HIV counseling as well as serologic screening during the prenatal period as a principal means of preventing infection in mothers and reducing the incidence of HIV infection in children.However, the rational design of prenatal counseling programs requires that the degree of risk-taking behavior, particularly unprotected or promiscuous sexual activity or intravenous drug use, be assessed in the population for whom the education is designed. There are few reports documenting the degree of HIV-related risky behavior practiced by women attending prenatal clinics. Therefore, the following survey was completed to assess the AIDS risks of women voluntarily pursuing prenatal care in inner-city clinics in Cleveland, Ohio, to help guide the design of perigestational interventions. METHODSStudy subjects were pregnant African American women attending one of five prenatal clinics in economically disadvantaged, geographically distinct neighborhoods in C...

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Is Monogamy or Committed Relationship Status a Marker for Low Sexual Risk among Men in Substance Abuse Treatment? Clinical and Methodological Considerations

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