The influence of psychosocial factors, alcohol, drug use on African-American women's high-risk sexual behavior.
OBJECTIVE
The present study examines psychosocial and behavioral influences, particularly drug and alcohol use, as correlates of inconsistent condom use and having multiple sexual partners during the past months among African-American women.


METHODS
The cross-sectional study, conducted between May and June 1996, recruited a convenience sample of 180 African-American women in Birmingham, Alabama. Women completed a face-to-face interview that assessed alcohol and drug use, sexual behaviors, depression, condom use, and negotiation skills.


RESULTS
The majority of women, 51.6% (n = 93), had used either alcohol or drugs during the previous month. Many women, 31.1%, consumed alcohol, 18.3% used marijuana, and 8.3% had smoked crack within the past month. Nearly 42.7% of women used condoms inconsistently in the past month and 13.3% of women had multiple sexual partners within the past month. A logistic regression model predicting inconsistent condom use indicated that women were less likely to use condoms if they consumed alcohol between 20 and 30 days of the month (OR = 2.8, 90% CI = 1.3-5.9) and if they had not negotiated condom use (OR = 32.4, 90% CI = 7.9-131.6). The logistic regression model predicting multiple sexual partners indicated that women were more likely to have multiple sexual partners if they had smoked crack in the past month (OR = 5.3, 90% CI = 1.6-18.2).


CONCLUSIONS
HIV sexual risk-reduction interventions for African-American women need to address the overlapping epidemics of drugs, alcohol, and STDs. Additionally, HIV sexual risk reduction efforts should be incorporated into existing drug and alcohol treatment programs and STD clinics.
Wingood
G M
GM
Department of Behavior Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta GA 30322, USA.
DiClemente
R J
RJ
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000407:Alabama / Q000453:epidemiology; D000428:Alcohol Drinking / Q000009:adverse effects*; D016009:Chi-Square Distribution; D017280:Condoms / Q000706:statistics & numerical data; D016001:Confidence Intervals; D016578:Crack Cocaine / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000208:ethnology / Q000635:transmission*; D015438:Health Behavior / Q000208:ethnology*; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D012309:Risk-Taking; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications*; D016387:Women's Health
D016578:Crack Cocaine