Saturday, 15 January 2005 - 12:00 PM

This presentation is part of: Poster Session II

HIV-risk Behaviors among Drug-Involved Mid-life and Older Minority Women

Purpose: Blacks and Latinas have the highest rates of HIV/AIDS among women in the United States. The risk factors for HIV transmission among this population are illicit drug use and unprotected sex. In recent years, there has been an increase in the number of mid-life and older minority women who are enrolled in methadone maintenance treatment programs. Aging, in general, however, has been thought to decrease drug and sexual risk behaviors. Traditionally, women were considered to age out of drug use, and become less sexually active as they grew older. As a result, very few studies have examined age-related HIV-risk behaviors. Very little data is available regarding HIV risk factors for mid-life and older women, especially in terms of their sexual risk behaviors. The purpose of this study is to examine HIV risk behaviors of drug involved Black and Latina women age 40 and older who are on methadone.

Methods: The sample for this paper is based on a study of HIV risk behaviors of randomly selected women (n=416) who were enrolled in a methadone maintenance treatment program. This study includes 159 women age 40 and older who self-identified as either Black or Latina and who had at least one male sex partner during the previous year. Sexual risk behaviors were measured by 1) the use of drugs (heroin, cocaine, and alcohol) while engaging in sex, and 2) inconsistent condom use with vaginal, oral and anal sex with male partners. Bivariate and multivariate analyses were conducted to examine the relationship between sexual risk behaviors with age, ethnicity, psychological distress, social support, income, education, and HIV status.

Results: Drug-related sexual risk behaviors were associated with psychological distress. Depression was associated with using heroin while having sex, and PTSD diagnosis was a significant predictor for using crack and alcohol while having sex. HIV negative status was associated with inconsistent condom use. Younger age was associated with higher rates of illicit drug use (heroin and crack cocaine) while having sex. Age, however, was not a significant predictor for unprotected vaginal sex. There were no significant differences in HIV-risk behaviors based on ethnicity.

Implications for Practice: Our findings support other studies that indicate associations between psychological distress, substance abuse and HIV-risk behaviors. Given that depression and PTSD diagnoses are more prevalent in women than in men and increase the risk of substance abuse, mental health assessment and referrals must be included in substance abuse treatment. The findings also suggest that mid-life and older women are equally at risk for HIV transmission through certain sexual risk behaviors, and that there is a need for age-appropriate HIV prevention and intervention strategies for this population.

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