title: Individual and Partner-Level Factors Associated with Condom Non-Use Among African American STI Clinic Attendees in the Deep South: An Event-Level Analysis.
abstract: The US HIV/AIDS epidemic is concentrated in the Deep South, yet factors contributing to HIV transmission are not fully understood. We examined relationships between substance use, sexual partnership characteristics, and condom non-use in an African American sample of STI clinic attendees in Jackson, Mississippi. We assessed condom non-use at last intercourse with up to three recent sexual partners reported by participants between January and June 2011. Participant- and partner-level correlates of condom non-use were examined using generalized estimating equations. The 1295 participants reported 2880 intercourse events, of which 1490 (51.7 %) involved condom non-use. Older age, lower educational attainment, reporting financial or material dependence on a sex partner, sex with a primary partner, and higher frequency of sex were associated with increased odds of condomless sex. HIV prevention efforts in the South should address underlying socioeconomic disparities and structural determinants that result in partner dependency and sexual risk behavior.
authors.affiliation: Department of Epidemiology, Brown University School of Public Health, 121 South Main St, Box G-S-121-2, Providence, RI, 02912, USA. brandon_marshall@brown.edu.
authors.forename: Brandon D L
authors.initials: BD
authors.lastname: Marshall
authors.affiliation: Department of Sociomedical Sciences, Columbia Mailman School of Public Health, 722 West 168th St, New York, NY, 10032, USA.
authors.forename: Amaya G
authors.initials: AG
authors.lastname: Perez-Brumer
authors.affiliation: Behavioral and Policy Sciences, RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: MacCarthy
authors.affiliation: Division of Infectious Diseases, University of Mississippi Medical Center, 2500 North State St, Jackson, MS, 39216, USA.
authors.forename: Leandro
authors.initials: L
authors.lastname: Mena
authors.affiliation: Division of Infectious Diseases, The Miriam Hospital, 164 Summit Ave, Providence, RI, 02906, USA.|The Warren Alpert School of Medicine, Brown University, 222 Richmond St, Providence, RI, 02903, USA.
authors.forename: Philip A
authors.initials: PA
authors.lastname: Chan
authors.affiliation: Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-2-121-5, Providence, RI, 02912, USA.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Towey
authors.affiliation: Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-2-121-5, Providence, RI, 02912, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Barnett
authors.affiliation: Division of Infectious Diseases, The Miriam Hospital, 164 Summit Ave, Providence, RI, 02906, USA.|Joint Master of Social Work Program, North Carolina A&T State University, 1601 East Market Street, 201 Gibbs Hall, Greensboro, NC, 27411, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Parker
authors.affiliation: Department of Internal Medicine, UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA.
authors.forename: Arti
authors.initials: A
authors.lastname: Barnes
authors.affiliation: Division of Infectious Diseases, The Miriam Hospital, 164 Summit Ave, Providence, RI, 02906, USA.|The Warren Alpert School of Medicine, Brown University, 222 Richmond St, Providence, RI, 02903, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Brinkley-Rubinstein
authors.affiliation: Department of Psychology, Wesleyan University, 207 High St, Middletown, CT, 06459-0408, USA.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Rose
authors.affiliation: Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-2-121-5, Providence, RI, 02912, USA.|The Rhode Island Public Health Institute, Brown University, Box G-S121-8, Providence, RI, 02912, USA.
authors.forename: Amy S
authors.initials: AS
authors.lastname: Nunn
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000517:prevention & control; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000554:Ambulatory Care Facilities; D017280:Condoms / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008922:Mississippi / Q000453:epidemiology; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex / Q000706:statistics & numerical data; D012725:Sexual Behavior; D012747:Sexual Partners; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology; D047568:Unsafe Sex / Q000706:statistics & numerical data
keywords: African Americans; Concurrency; Contraceptive use; HIV; Substance use