Sexual Risk Behaviors among African-American and Hispanic Women in Five Counties in the Southeastern United States: 2008–2009

Abstract

Purpose We examined sexual risk behaviors and unrecognized HIV infection among heterosexually active African American (AA) and Hispanic women. Methods Women not previously diagnosed with HIV infection were recruited in rural counties in North Carolina (AA) and Alabama (AA), and an urban county in southern Florida (Hispanic) using multiple methods. They completed a computer-administered questionnaire and were tested for HIV infection. Results Between October 2008 and September 2009, 1527 women (1013 AA and 514 Hispanic) enrolled in the study. Median age was 35 years (range 18-59), 33% were married or living as married, 50% had an annual household income of $12,000 or less, and 56% were employed full or part time. Two women (0.13%) tested HIV-positive. In the past 12 months, 19% had been diagnosed with a sexually transmitted disease (other than HIV), 87% engaged in unprotected vaginal intercourse (UVI), and 26% engaged in unprotected anal intercourse (UAI). In multivariate analysis, UAI was significantly (p < 0.05) more likely among those who reported: ever being pregnant, binge drinking in the past 30 days, ever exchanging sex for things needed or wanted, engaging in UVI, or being of Hispanic ethnicity. UAI was also more likely to occur with partners with whom women had a current or past relationship as opposed to casual partners. Conclusions A high percentage of our sample of heterosexually active women of color had recently engaged in sexual risk behaviors, particularly UAI. More research is needed to elucidate the interpersonal dynamics that may promote this high-risk behavior. Educational messages that explicitly address the risks of heterosexual anal intercourse need to be developed for heterosexually active women and their male partners.

Pharmacokinetic and Pharmacodynamic Evaluation following Vaginal Application of IQB3002, a Dual-Chamber Microbicide Gel Containing the Nonnucleoside Reverse Transcriptase Inhibitor IQP-0528 in Rhesus Macaques

“…However, several behavioral studies and clinical trial reports have shown that women also engage in unprotected receptive anal intercourse (RAI), with the highest rates of RAI being found among female sex workers and patients at sexually transmitted infection clinics (1)(2)(3)(4)(5)(6)(7)(8)(9). In addition, a recent metaanalysis demonstrated that the estimated per-act human immunodeficiency (HIV) transmission risk (per 10,000 exposures) for RAI is 138, compared to 11, 8, and 4 for insertive anal intercourse, receptive penile-vaginal intercourse, and insertive penile-vaginal intercourse, respectively (10).…”

Factors Associated with African American Women’s Sexual Health and Risk Behavior: A Mixed Methods Study

“…In the previously mentioned Murray et al study, social factors involving parental and societal influence seemed to shape women's attitudes regarding their relationships and acceptance of the possibility of pregnancy (2013). Other empirical findings reveal that social determinants including financial adversity, relationship status, gender roles, and family or household structure have the potential to manipulate and distinguish the emotional and relational factors that underlie AAWs reproductive and sexual health (McLellan-Lemal et al, 2012;Sharpe et al, 2012).…”

“…The identification of patterns of sexual risk behaviors and development of interventions to reduce or eliminate those behaviors has long since been the focus of research studies examining the sexual and reproductive health of AAW (McLellan-Lemal et al, 2012;Neblett et al, 2011;Reid et al, 2014). With heterosexual contact being attributed to most new HIV infections and other STIs in AAW, behavioral factors frequently identified in the examination of sexual risk for these women include: inconsistent condom use, having multiple or concurrent sexual partners, and the use of illicit drugs (Centers for Disease Control and Prevention, 2014b;McLellan-Lemal et al, 2013;Perkins, Stennis, Taylor Spriggs, Kwegyir-Afful, & Prather, 2014).…”

“…For AAW, sexual risk is often measured by the practice of multiple sexual behaviors associated with the transmission of STIs including HIV infection (McLellan-Lemal et al, 2012). In most research studies examining AAW's sexual behavior, consistency in condom use, while varied in its definition, is typically characterized as women's use of condoms during each vaginal or anal sexual encounter occurring over a duration of 60 -90 days (Crosby et al, 2013;DePadilla, Windle, Wingood, Cooper, & DiClemente, 2011).…”

“…Sexual risk behaviors unique to AAW have been shown to increase the risk of acquiring STIs and contribute to the negative health outcomes affecting AAW (McLellan-Lemal et al, 2012;Neblett et al, 2011;Pfileger, Cook, Niccolai, & Connell, 2013). In addition to behavioral risks, other factors identified as contributing to disparate rates of STI infection and unintended pregnancy in this group are largely emotional and relational in nature.…”