HIV in African American women: Evidence that elevated rate of infection cannot be explained solely on the basis of known individual risk behaviors.

Objective: To compare known individual risk behaviors in African American, Whites, and Hispanic women as found in the literature and support those findings by analyzing data available through NHANES in order to find out if the higher rate of HIV infection in African American women is a direct result of higher risk behaviors. Those risk behaviors include lower rates of condom use, higher rates of drug use including those taken intravenously, higher rates of risky sex habits, higher number of sexual partners over their lifetime, and a more extensive history of sexually transmitted infections. This study also aims to draw attention to larger factors that may foster the conditions for increased HIV rates in African American women. Results: The perception that higher rate of HIV infection is the result of increased risk factors among African American women is not supported either in the literature or in the analysis of NHANES data. For instance, results from data analysis found that African American women had fewer average number of sexual partners (P ≤ 0.05), lower overall rate of drug use (P ≤ 0.01), lower rates of risky sexual practices (P ≤ 0.01), but more likely to report a history of STIs (P ≤ 0.01) than Whites. The literature also confirmed that current HIV testing recommendations do not cover a large enough portion of the population to make a significant impact on HIV incidence. In addition, socioeconomic situations further exacerbate the conditions favorable to the transmission of the disease in African American women. Conclusion: Prevention programs that rely on individual risk behaviors alone may not be enough to reduce HIV rates in African American women, though those same programs may be working in MSM. Programs that address socioeconomic disparities and testing recommendations that cover more people are needed in order to drive down HIV infection rates in African American women