title: The changing age of HIV: sexual risk among older African American women living in rural communities.
abstract: BACKGROUND
  African American women aged 50 and older are disproportionately affected by the HIV/AIDS epidemic. Despite African Americans making up 11% of all older women in the United States, in 2001, they accounted for more than 50% of AIDS cases among older women and more than 65% of HIV cases among older women. Using the AIDS Risk Reduction Model as a conceptual framework, this study investigated HIV risk behavior among older rural African American women (mean age = 58 years).
  
  
  METHODS
  A cross-sectional survey was conducted (n = 181) in three rural counties in South Carolina.
  
  
  RESULTS
  Most (67%) of the women had at least one sex partner in the past five years, and of these, more than half (59.5%) reported at least one sexual risk behavior. High-risk behavior was associated with less education, lower condom use self-efficacy, more peers who discussed HIV-related risk behavior, and less comfort communicating with partners about sex.
  
  
  CONCLUSIONS
  A significant proportion of older African American women living in rural counties are at increased risk for HIV infection, suggesting an urgent need for HIV prevention efforts to target this population.
authors.affiliation: Department of Psychiatry & Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee 53202, USA. awinning@mcw.edu
authors.forename: April
authors.initials: A
authors.lastname: Winningham
authors.forename: Sara
authors.initials: S
authors.lastname: Corwin
authors.forename: Charity
authors.initials: C
authors.lastname: Moore
authors.forename: Donna
authors.initials: D
authors.lastname: Richter
authors.forename: Roger
authors.initials: R
authors.lastname: Sargent
authors.forename: Cheryl
authors.initials: C
authors.lastname: Gore-Felton
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D011314:Preventive Health Services / Q000706:statistics & numerical data; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012725:Sexual Behavior; D012747:Sexual Partners; D012959:Socioeconomic Factors