AIDS Protection and Contraception among African American, Hispanic and White Women

By Hines, Alice M.; Graves, Karen L. | Health and Social Work, August 1998 | Go to article overview

AIDS Protection and Contraception among African American, Hispanic and White Women


Hines, Alice M., Graves, Karen L., Health and Social Work


Women have become the fastest growing subgroup of AIDS cases in the United States and as of 1992 constituted more than 10 percent of all AIDS cases (Centers for Disease Control [CDC], 1992). Most women with AIDS are of reproductive age; approximately 53 percent are African American, and 16 percent are Hispanic (CDC, 1991). In 1993 women who acquired HIV through heterosexual contact increased 139 percent over 1992. Fifty percent of these cases were African American, 24 percent Hispanic, and 25 percent white. Overall, most of the heterosexually acquired AIDS cases were attributed to contact with a partner with HIV infection or AIDS whose risk was unreported or unknown (CDC, 1994).

Prevention efforts to curtail the spread of AIDS have focused primarily on the adaptation of latex condoms used by men during intercourse. In addition to risk of AIDS, negative results of not using condoms can include the contraction and spread of other sexually transmitted diseases (STDs) and unintended pregnancies. To address the overall reproductive needs and risks of women, it is important to examine how condom use is related to the use of other methods to prevent unintended pregnancies (Roper, Peterson, & Curran, 1993). Because AIDS risk-reduction activities are often identical and linked with contraceptive efforts, especially condom use, it may be useful to look at contraceptive use behaviors in terms of AIDS protection and effective birth control efforts to uncover sexual practices and factors related to behavior as a means of targeting effective AIDS-related preventive measures (Mays & Cochran, 1988). Sexual behavior is influenced by a variety of racial, cultural, and religious factors in addition to factors related to life stage and socioeconomic status and factors related to the event itself. Knowledge of ways in which these factors relate to safer sexual practices can be used to inform interventions that can then be tailored to the cultural and social realities of a particular group.

In addition, recent studies have shown that women, including African American and Hispanic women, are aware of AIDS and ways to prevent the disease, but are not changing their behavior (Caetano & Hines, 1995). This finding points to the need to know more about each particular ethnic group. An accurate assessment of women's sexual behavior, including contraceptive-related protection is critical to the development of effective HIV-prevention programs.

The current study describes the sexual practices of heterosexual women in a population-based sample that oversampled African American and Hispanic women, yielding a sample large enough to look at within-group differences. This study also examines the most recent sexual encounter as a way of obtaining more accurate reports of behavior. The "critical incident" technique involves the study of behaviors linked to a specific event. The purpose of this article is to examine characteristics of women in each ethnic group that are related to effective AIDS protection and effective methods of birth control during the 12 months preceding the interview.

METHODS

Sampling

Data were collected in 1991 and 1992 as part of a follow-up survey to a 1984 National Alcohol Survey, the first national household survey to study drinking attitudes, patterns, and problems of African Americans, Hispanics, and the general population. The sample population for the 1984 survey was selected through a multistage probability procedure from among individuals living in households in the 48 coterminous United States. The sampling method of the 1984 survey has been described in detail elsewhere (Santos, 1991).

The sampling design used for the 1991-92 follow up consisted of two samples: a reinterview sample of respondents randomly selected as part of the 1984 national survey and an additional random sample of 18- to 25-year-olds, to replace the 18- to 25-year-olds in the original 1984 sample. …

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