A case-control study of factors associated with HIV infection among black women.
OBJECTIVE
To identify social, behavioral and epidemiologic factors associated with HIV infection among HIV-infected and HIV-uninfected black women residing in North Carolina.


METHODS
A case-control study conducted in August 2004 in North Carolina.


METHODS
Cases were 18-40-year-old women with HIV infections diagnosed from 2003-2004. Controls were 18-40-yearold, HIV-negative heterosexually active women recruited from HIV testing sites. Five focus group discussions were also conducted with women not participating in the case-control study.


RESULTS
Multivariate analyses of 31 cases and 101 controls showed that HIV-positive women were more likely to receive public assistance [adjusted odds ratio (aOR) 7.3; 95% confidence interval (CI) 2.1, 26.0], to report a history of genital herpes infection (aOR 10.6; 95% CI 2.4, 47.2), and were less likely to have discussed a variety of sexual and behavioral issues relevant to risk of HIV infection with their male partners (aOR 0.6; 95% CI 0.4, 0.8). Focus group participants indicated that financial and social demands created competing challenges for making HIV prevention a priority.


CONCLUSIONS
Inadequate communication between black women and their sexual partners may create barriers to sexual and behavioral risk reduction. A multidimensional approach that addresses both biological factors such as herpes infection and socioeconomic factors may be needed to reduce HIV transmission in this population.
Forna
Fatu M
FM
Epidemic Intelligence Service, Office of Workforce and Career Development, Career Development Division, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-04, Atlanta, GA 30333, USA. fforna@cdc.gov
Fitzpatrick
Lisa
L
Adimora
Adaora A
AA
McLellan-Lemal
Eleanor
E
Leone
Peter
P
Brooks
John T
JT
Marks
Gary
G
Greenberg
Alan
A
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000208:ethnology* / Q000635:transmission; D006801:Humans; D015999:Multivariate Analysis; D009657:North Carolina / Q000453:epidemiology; D011632:Public Assistance / Q000706:statistics & numerical data; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors