Factors related to HIV risk: Predictors of risky sexual behavior and attitudes toward microbicide use

According to the World Health Organization, by the year 2000 women will account for most of the new acquired immunodeficiency syndrome (AIDS) infections. There were two overall goals of this study: first to identify predictors of risky sexual behavior in women and second to develop a scale measuring attitudes toward microbicide use for women. Phase one evaluated a model predicting risky sexual behavior. This model was built on earlier work by Johnsen (1995). Factors hypothesized to mediate the relationship between sexual abuse, family functioning, and HIV risk included: adult victimization, condom assertiveness, dissociation, powerlessness, and anticipated partner reaction. The sample was 268 women from a Family Planning Clinic (FPC) and a Primary Medical Care Clinic (PMCC). The mean age was 23 years for the FPC and 32 years for the PMCC. Eighty six percent of the FPC and 49% of the PMCC were Caucasian. Results for the full hypothesized model results were a $\chi\sp2(230) = 357,$ Comparative Fit Index (CFI) =.96, and Root Mean Square Residual (RMSR) =.07 indicating excellent overall fit. The Independent Variables (IVs) and mediators accounted for 10% and 29% of the variance in partner risk and unprotected sex, respectively. Unprotected sex was associated with a less positive family environment, less adult victimization, less powerlessness, and less condom assertiveness. Partner risk was predicted by more dissociation. A separate model was tested in which sexual Powerlessness was a mediator between childhood sexual abuse and family environment and the other mediators. Results were a $\chi\sp2(234) = 384,$ CFI =.94, and RMSR =.06 indicating excellent overall fit. The IVs and mediators accounted for 9% and 34% of the variance in the HIV risk behaviors. Next, a measure of microbicide use was developed. Principal Components Analysis produced four factors, which were confirmed utilizing Confirmatory Factor Analysis. Most of the sexually active women in the sample (88%) said they would be willing to think about using microbicides. Conversely, over 56% indicated no intention of using condoms consistently with their main partner in the foreseeable future. Implications for further research and interventions as well as study limitation are discussed