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

In this study, the authors examined sexual risk behaviors and unrecognized HIV infection among heterosexually active African-American and Hispanic women. Multiple methods were used to recruit women not previously diagnosed with HIV infection in rural counties in North Carolina (African-American) and Alabama (African-American), and an urban county in southern Florida (Hispanic). The participants completed a computer-assisted questionnaire and underwent HIV testing.

A total of 1,527 women (1,013 African-American; 514 Hispanic) were enrolled between October 2008 and September 2009. The women ranged in age from 18 to 59 (median age=35). Thirty-three percent were married or living as married. Fifty percent reported an annual household income of $12,000 or less; 56 percent were employed full- or part-time.

Two of the women (0.13 percent) tested HIV-positive. In the preceding 12 months, 19 percent had been diagnosed with an STD (other than HIV); 87 percent had engaged in unprotected vaginal intercourse (UVI); and 26 percent had had unprotected anal intercourse (UAI).

Multivariate analysis showed UAI was significantly (p<.05) more likely among the women who reported ever being pregnant, binge drinking in the previous 30 days, ever exchanging sex for things they needed or wanted, engaging in UVI or being of Hispanic ethnicity. As opposed to casual partners, UAI was more likely with partners with whom the participants had a current or past relationship.

"A high percentage of our sample of heterosexually active women of color had recently engaged in sexual risk behaviors, particularly UAI," the authors concluded. "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."

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