The Likelihood of Condom Use with Steady and Casual Partners among Low-Income African Americans

By Kanu, Mohamed; Williams, Charles et al. | Journal of the National Society of Allied Health, Annual 2009 | Go to article overview

The Likelihood of Condom Use with Steady and Casual Partners among Low-Income African Americans


Kanu, Mohamed, Williams, Charles, Hepler, Nancy, Journal of the National Society of Allied Health


Introduction

African Americans residing in high-risk inner-city environments have been disproportionately affected by the epidemics of human immunodeficiency virus (HIV) and other sexually transmitted diseases (CDC Report, 2004). Understanding behavioral factors such as human sexuality and the practice of safe sex using condoms are critical for developing effective interventions for HIV/AIDS prevention programs.

Some epidemiologic data show that women, African Americans, MSM (men having sex with men), and persons at risk due to heterosexual intercourse or needle sharing related to injecting drug use have a disproportionately higher risk of AIDS and human immunodeficiency virus (HIV) infection (Tennessee Health Status Report, 2000). Of the 784 new cases of HIV in Tennessee in 2000, 233 (30%) were females, 511 (65%) were African Americans, 319 (41%) were men having sex with men, 177 (23%) were heterosexuals, and 79 (10%) shared needles and were related to injecting drug use. More recent data suggest that although the rate of HIV infections has remained fairly stable for the past few years, African Americans continue to bear the greatest burden of the disease. During 2004, 59% of newly diagnosed HIV/AIDS cases were among African-Americans, who constitute only 16% of the population of Tennessee. (Tennessee Department of Health Report, 2005). Many funded prevention programs designed to increase self-protective behaviors are urgently needed to avert a further increase in HIV infection among this population.

Even though HIV infection is purported to be the highest among African Americans, there is a paucity of condom studies with African Americans. While some studies conducted in the North, (Guttmacher et al. 1999) and in the West (Marin, Gomez & Tschann, 1993; DiClemente, Lodocco, & Grinstead, 1996) have focused primarily on demographic predictors of condom use behavior, studies conducted in the southern United States have explored prevalence and select correlates of consistent condom use (Chartterjee, Hosain, & Williams, 2006). In the latter study, researchers found higher consistent use of condoms among steady partners than among casual ones. However, the availability of condoms as a predictor of its use has not been tested or explored. The authors proposed inconclusively that the inconsistent use of condoms with casual partners was possibly determined by factors including the lack of availability of condoms.

The purpose of the current study was to determine if the availability of condoms was a predictor of its use among casual and steady partners. The study also explored respondents' perceptions about the difficulties and consequences of condom use in a high-risk area for HIV.

Methodology

The study was approved by the Institutional Review Board of the University of Memphis. All participants were informed about the nature and purpose of the study. Participation in the study was voluntary. To assure confidentiality, names and other identifiers of participants (i.e., addresses, telephone numbers, etc.) were not requested or recorded in the survey. Data were aggregated and reported to ensure confidentiality of information.

The geographic area of north Nashville was selected as the study site because of the high incidence of HIV and STD. At the time of the study, Nashville had one of the highest sexually transmitted disease rates in the nation, with the highest syphilis rate and in the top 20 for cities with the highest gonorrhea rates (CDC, 2002). The zip code area (37205-37217) in North Nashville) where the study was conducted had the highest rates of STDs in the city.

A systematic random sample of 400 was selected from a list of heads-of-households at six public housing developments in the study area. African American community health advocates who were known to the residents in the community and had experience with prior door knock surveys in the area were trained to follow the sample plan; adhere to consent and confidentiality protocol and administer the surveys. …

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