HIV Risk Behavior Among A Sample Of Young Black Women

Background: The majority of HIV/AIDS research conducted to date has focused on men who have sex with men (MSM), adolescents, and under educated minority women living in poverty. However, another potentially high-risk group - young Black college women – has not been well studied. By virtue of being female, members of an ethnic minority, and college students, young Black college women face multiple risks for contracting HIV/AIDS. For instance, African American women now account for 72% of all new female HIV/AIDS cases and experience rates of HIV/AIDS at least 25 times greater than their white counterparts. To redress this important gap in the research literature the present study investigated factors associated with failure to use condoms among a sample of Black college women.

Methods: A convenience sample of 189 Black women between the ages of 18 and 24 from an Historically Black University in the southern region of the country completed a 76-item self-administered questionnaire. The questionnaire included previously developed and validated measures of interpersonal and behavioral risk factors derived from Wingood and DiClemente's (2002) revision of the theory of gender and power: frequency of substance use, the ability to negotiate condom use under different circumstances (i.e., self-efficacy), and type of sexual relationship (casual/committed). Ordinal logistic regression analysis was used to examine the associations between these factors and the likelihood of regular condom use as measured on a 5-point scale that ranged from “very unlikely” to “very likely”.

Results: Contrary to expectations, a substantial proportion of the sample (42.6%) reported they did not use condoms regularly. Of these, over one-fourth of the women surveyed (27.8%) reported they were very unlikely or unlikely to use condoms regularly with another 15% saying they were only somewhat likely. Examining condom use in a multivariate context, the ordinal logistic regression model was statistically significant (LR chi-square = 8.87, p < .05). Women reporting higher levels of self-efficacy (OR = 1.57) and those who were in a casual versus a committed relationship (OR = 1.92) had increased odds of reporting more regular condom use. Higher levels of self-reported substance use in the past year, however, were associated with lower likelihoods of regular condom use (OR = .57).

Conclusion and Implications: These findings indicate that young college-educated Black women exhibit some of the same high-risk behaviors as their low-income, uneducated counterparts, such as inconsistent condom use while under the influence of drugs and alcohol, using condoms less often and less consistently with partners they deem safe, such as boyfriends, and having low levels of condom use self-efficacy, all of which increase their risk for contracting HIV. As a result, social workers need to work with and within college administrations to develop culturally sensitive interventions that target the specific high-risk behaviors associated with failing to use condoms in a population that has been mistakenly assumed to be practicing safer sex more often than their lower income and less well educated counterparts.