Abstract
OBJECTIVE: To identify social, behavioral and epidemiologic factors associated with HIV infection among HIV-infected and HIV-uninfected black women residing in North Carolina. DESIGN: A case-control study conducted in August 2004 in North Carolina. METHODS: Cases were 18-40-year-old women with HIV infections diagnosed from 2003-2004. Controls were 18-40-yearold, HIV-negative heterosexually active women recruited from HIV testing sites. Five focus group discussions were also conducted with women not participating in the case-control study. RESULTS: Multivariate analyses of 31 cases and 101 controls showed that HIV-positive women were more likely to receive public assistance [adjusted odds ratio (aOR) 7.3; 95% confidence interval (CI) 2.1, 26.0], to report a history of genital herpes infection (aOR 10.6; 95% CI 2.4, 47.2), and were less likely to have discussed a variety of sexual and behavioral issues relevant to risk of HIV infection with their male partners (aOR 0.6; 95% CI 0.4, 0.8). Focus group participants indicated that financial and social demands created competing challenges for making HIV prevention a priority. CONCLUSIONS: Inadequate communication between black women and their sexual partners may create barriers to sexual and behavioral risk reduction. A multidimensional approach that addresses both biological factors such as herpes infection and socioeconomic factors may be needed to reduce HIV transmission in this population.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Centers for Disease Control and Prevention (CDC) HIV transmission among black college student and non-student men who have sex with men--North Carolina, 2003. MMWR Morb Mortal Wkly Rep. 2004 Aug 20;53(32):731–734. [PubMed] [Google Scholar]
- Centers for Disease Control and Prevention (CDC) Update: adverse events following civilian smallpox vaccination--United States, 2003. MMWR Morb Mortal Wkly Rep. 2004 Feb 13;53(5):106–107. [PubMed] [Google Scholar]
- Freedman Ellie, Mindel Adrian. Epidemiology of herpes and HIV co-infection. J HIV Ther. 2004 Feb;9(1):4–8. [PubMed] [Google Scholar]
- Hader S. L., Smith D. K., Moore J. S., Holmberg S. D. HIV infection in women in the United States: status at the Millennium. JAMA. 2001 Mar 7;285(9):1186–1192. doi: 10.1001/jama.285.9.1186. [DOI] [PubMed] [Google Scholar]
- Karon J. M., Fleming P. L., Steketee R. W., De Cock K. M. HIV in the United States at the turn of the century: an epidemic in transition. Am J Public Health. 2001 Jul;91(7):1060–1068. doi: 10.2105/ajph.91.7.1060. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Klevens R. M., Fleming P. L., Neal J. J., Li J. Knowledge of partner risk and secondary transmission of HIV. Am J Prev Med. 2001 May;20(4):277–281. doi: 10.1016/s0749-3797(01)00297-5. [DOI] [PubMed] [Google Scholar]
- Montgomery J. P., Mokotoff E. D., Gentry A. C., Blair J. M. The extent of bisexual behaviour in HIV-infected men and implications for transmission to their female sex partners. AIDS Care. 2003 Dec;15(6):829–837. doi: 10.1080/09540120310001618676. [DOI] [PubMed] [Google Scholar]
- Rothenberg R. B., Wasserheit J. N., St Louis M. E., Douglas J. M. The effect of treating sexually transmitted diseases on the transmission of HIV in dually infected persons: a clinic-based estimate. Ad Hoc STD/HIV Transmission Group. Sex Transm Dis. 2000 Aug;27(7):411–416. doi: 10.1097/00007435-200008000-00006. [DOI] [PubMed] [Google Scholar]
- Salazar Laura F., Crosby Richard A., DiClemente Ralph J., Wingood Gina M., Lescano Celia M., Brown Larry K., Harrington Kathy, Davies Susan. Self-esteem and theoretical mediators of safer sex among African American female adolescents: implications for sexual risk reduction interventions. Health Educ Behav. 2005 Jun;32(3):413–427. doi: 10.1177/1090198104272335. [DOI] [PubMed] [Google Scholar]