Sexual Risk Factors for HIV and Violence among Puerto Rican Women in New York City
Moreno, Claudia L., Morrill, Allison C., El-Bassel, Nabila, Health and Social Work
This study investigated intimate partner violence (IPV) and heterosexual risk factors for HIV/AIDS and other sexually transmitted infections (STIs) among a convenience sample of women of Puerto Rican heritage living in New York City (NYC). Investigators sought to determine whether those who were born in the continental United States or who preferred English over Spanish experience more IPV and greater HIV risks than their counterparts who were born in the Commonwealth of Puerto Rico or preferred to speak Spanish.
HETEROSEXUAL RISK AND PUERTO RICAN WOMEN
HIV continues to be a threat to Latinas in the United States and is the fourth leading cause of death for Latinas between the ages of 35 to 44 years (Centers for Disease Control and Prevention [CDC], 2008). Those most affected by HIV/AIDS are Latinas in their most reproductive years (ages 25 to 44), who account for 70 percent of AIDS cases and represent 15 percent of all women living with HIV/AIDS. Heterosexual intercourse is the most common route of HIV transmission for Latinas (CDC, 2008).
Puerto Ricans are the second largest group of Hispanics in the United States (Oropesa, Landale, & Greif, 2008). Puerto Ricans make up only 9.6 percent of the Hispanic population in the United States but represent 58.0 percent of the AIDS cases among Latinos. Among Latino subgroups, men and "women born in the Commonwealth of Puerto Rico have the highest incidence of HIV; the two most dominant transmission routes are heterosexual contact (38 percent) and injection drug use (39 percent) (CDC, 2009). Injection drug use has been found to be higher among Puerto Ricans than any other Latino subgroup (Kang, Deren, Andia, Colon, & Robles, 2001; Montoya, Bell, Richard, Carlson, & Trevino, 1999).
Among its many Hispanic ethnicities, NYC has one of the largest concentrations of Puerto Ricans in the continental United States (Oropesa et al., 2008). Although Hispanics represented 27 percent of the population in NYC, they accounted for 29 percent of newly diagnosed HIV cases in 2007 (New York City Department of Health and Mental Hygiene, 2009). Of Hispanic HIV cases, 26% were among Latinas (New York City Department of Health and Mental Hygiene, 2009). Frequent cyclical migration patterns of people of Puerto Rican heritage between Puerto Rico and the continental United States have been well documented; frequent cyclical migration patterns are of concern because they can lead to higher incidence rates of HIV/AIDS in both communities (Ellis, Convay, & Bailey, 1996).
Previous research among Puerto Rican women has identified several categories of factors that may place them at increased risk for HIV: social norms, strict gender roles, power differentials, and cultural scripts such as machismo and marianismo (Moreno & El-Bassel, 2007; Ortiz-Torres, Serrano-Garcia, & Torres-Burgos, 2000; Rafaelli & Suarez Al-Adam, 1998); structural factors, including social marginalization and financial hardships (Moreno, 2007; Rivera, 1994); and beliefs systems, such as having misunderstandings about how HIV/AIDS and STIs are transmitted (Ortiz-Torres et al., 2000). There is also a limited knowledge regarding the health-specific needs of the diversity of Latinas (Amaro & de la Torre, 2002). Although machismo and marianismo are not unique to Latinos, they are present in some Latinos with different degrees of intensity. Machismo refers to men's being overpowering, dictating certain sexual behaviors such as having multiple sexual partners and being more informed about sex than women. Marianismo refers to being submissive and passive, dictating some sexual behaviors such as being ignorant about sex and STIs and letting a male partner decide about all sexual matters (Moreno, 2007).
IPV AND PUERTO RICAN WOMEN
In the United States, Latinos represent 15.8 percent of the population (U.S. Census Bureau, 2010) but account for 34 percent of the cases of IPV (Bureau of Justice Statistics, 2000). …