Determinants of condom use among HIV-infected low-income, urban African-American women: The role of relationship factors.

The objective of this research was to describe the prevalence and determinants of condom use among HIV-infected African-American women. Promoting this behavior is of great public health concern because of the known efficacy of condoms in curbing the spread of HIV to uninfected male partners, and in protecting the health of immunosuppressed women against infection with sexually transmitted pathogens. Three types of predictors, beliefs about condoms, attitude toward condom use and relationship factors, were examined using a cross-sectional study design. Face-to-face interviews were conducted with 107 HIV-infected African-American women attending an outpatient HIV/AIDS clinic in urban Detroit. Of the 70 women who reported having at least one male sexual partner in the past three months, 49 (70%) reported using a condom at last intercourse. After controlling for the confounding effects of age, and number of sexual partners in the past six months, in logistic regression models, partner's HIV status, and having revealed one's own HIV status to the partner were the strongest predictors of condom use at last intercourse. Women were more likely to use condoms if they perceived their partner to be HIV seronegative as compared to seropositive partners or partners whose HIV status was unknown. Qualitative data obtained in the second part of the interview indicated that both revealers and non-revealers (of their HIV status) felt they were demonstrating responsible behavior to protecting their partner's health, the former by warning their partner of his risk of HIV infection, and the latter by using condoms. Other relationship factors of special interest in this study such as commitment to and duration of the relationship were not associated with condom use. The implications for these results for the development of theoretical models to guide research in this area, and for health practice, are discussed.PhDEpidemiologic ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/104093/1/9500898.pdfDescription of 9500898.pdf : Restricted to UM users only